Right Ventricular Function in Cardiovascular Disease, Part I Anatomy, Physiology, Aging, and Functional Assessment of the Right Ventricle
TLDR
The goal of the present review is to offer a clinical perspective on RV structure and function, using echocardiography and magnetic resonance imaging to create new opportunities for the study of RV anatomy and physiology.Abstract:
In 1616, Sir William Harvey was the first to describe the importance of right ventricular (RV) function in his seminal treatise, De Motu Cordis : “Thus the right ventricle may be said to be made for the sake of transmitting blood through the lungs, not for nourishing them.”1,2 For many years that followed, emphasis in cardiology was placed on left ventricular (LV) physiology, overshadowing the study of the RV. In the first half of the 20th century, the study of RV function was limited to a small group of investigators who were intrigued by the hypothesis that human circulation could function adequately without RV contractile function.3 Their studies, however, were based on an open pericardial dog model, which failed to take into account the complex nature of ventricular interaction. In the early 1950s through the 1970s, cardiac surgeons recognized the importance of right-sided function as they evaluated procedures to palliate right-heart hypoplasia. Since then, the importance of RV function has been recognized in heart failure, RV myocardial infarction, congenital heart disease and pulmonary hypertension. More recently, advances in echocardiography and magnetic resonance imaging have created new opportunities for the study of RV anatomy and physiology.
The goal of the present review is to offer a clinical perspective on RV structure and function. In the first part, we discuss the anatomy, physiology, aging, and assessment of the RV. In the second part, we discuss the pathophysiology, clinical importance, and management of RV failure.
### Macroscopic Anatomy of the RV
In the normal heart, the RV is the most anteriorly situated cardiac chamber and lies immediately behind the sternum. In the absence of transposition of great arteries, the RV is delimited by the annulus of the tricuspid valve and by the pulmonary valve. As suggested by Goor and Lillehi,4 the RV can be described in …read more
Citations
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The pulmonary artery pulsatility index identifies severe right ventricular dysfunction in acute inferior myocardial infarction.
Ravi Korabathina,Kevin S. Heffernan,Vikram Paruchuri,Ayan R. Patel,James O. Mudd,Jordan M. Prutkin,Nicole M. Orr,Andrew Weintraub,Carey Kimmelstiel,Navin K. Kapur +9 more
TL;DR: A novel hemodynamic index is defined, the pulmonary artery pulsatility index (PAPi), and whether the PAPi correlates with severe RVD in acute IWMI is explored.
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A comprehensive echocardiographic protocol for assessing neonatal right ventricular dimensions and function in the transitional period: normative data and z scores.
Amish Jain,Amish Jain,Adel Mohamed,Adel Mohamed,Afif El-Khuffash,Kim A. Connelly,Kim A. Connelly,Frederic Dallaire,Robert P. Jankov,Patrick J. McNamara,Luc Mertens,Luc Mertens +11 more
TL;DR: A comprehensive echocardiographic protocol for neonatal RV imaging is described to establish reference ranges, and describe the effect of physiologic postnatal transition on RV dimensions and function to facilitate future investigations of RV dysfunction in neonatal cardiopulmonary disorders.
Journal ArticleDOI
Right Ventricular Structure Is Associated With the Risk of Heart Failure and Cardiovascular Death The Multi-Ethnic Study of Atherosclerosis (MESA)-Right Ventricle Study
Steven M. Kawut,R. Graham Barr,Joao A.C. Lima,Amy Praestgaard,W. Craig Johnson,Harjit Chahal,Kofo O. Ogunyankin,Michael R. Bristow,Jorge R. Kizer,Harikrishna Tandri,David A. Bluemke +10 more
TL;DR: In this article, the authors examined the association of abnormal right ventricular (RV) structure and function with the risk of heart failure or cardiovascular death in a population-based multiethnic sample free of clinical cardiovascular disease at baseline.
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Right ventricular-left ventricular interaction in adults with Tetralogy of Fallot: a combined cardiac magnetic resonance and echocardiographic speckle tracking study.
Aleksander Kempny,Gerhard-Paul Diller,Stefan Orwat,Gerrit Kaleschke,Gregor Kerckhoff,Alexander C. Bunck,David Maintz,Helmut Baumgartner +7 more
TL;DR: Left and right ventricular function both by CMR and speckle-tracking is interrelated in adults with repaired ToF, suggesting subclinical LV myocardial damage.
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The Physiologically Difficult Airway.
Jarrod Mosier,Raj Joshi,Cameron Hypes,Garrett S. Pacheco,Terence D. Valenzuela,John C. Sakles +5 more
TL;DR: The physiologically difficult airway is described, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management.
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