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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4HNE Impairs Myocardial Bioenergetics in Congenital Heart Disease-Induced Right Ventricular Failure.
Hyun Tae V. Hwang,Nefthi Sandeep,Sharon L. Paige,Sara Ranjbarvaziri,Dong-Qing Hu,Mingming Zhao,Ingrid S. Lan,Michael Coronado,Kristina B. Kooiker,Sean M. Wu,Giovanni Fajardo,Daniel Bernstein,Sushma Reddy +12 more
TL;DR: Strategies to decrease lipid peroxidation could improve mitochondrial energy generation and cardiomyocyte survival and improve RV failure in patients with congenital heart disease.
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The Achilles' heel of left ventricular assist device therapy: right ventricle.
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Stunning and Right Ventricular Dysfunction Is Induced by Coronary Balloon Occlusion and Rapid Pacing in Humans: Insights From Right Ventricular Conductance Catheter Studies.
Richard G. Axell,Richard G. Axell,Joel P. Giblett,Joel P. Giblett,Paul A. White,Paul A. White,Andrew A. Klein,James Hampton‐Til,Michael O'Sullivan,Denise Braganza,William R. Davies,Nick E.J. West,Cameron G. Densem,Stephen P. Hoole +13 more
TL;DR: RP and right coronary artery balloon occlusion both cause ischemicright ventricular dysfunction with stunning observed later during the procedure, which may have intraoperative implications in patients without right ventricular functional reserve.
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Use of novel echocardiographic techniques to assess right ventricular geometry and function.
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Echocardiographic evaluation of diastolic function in the setting of pulmonary hypertension.
TL;DR: This review provides a comprehensive review of the literature and provides a framework by which to assess diastolic dysfunction echocardiographically in the setting of pulmonary hypertension.
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