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
More filters
Journal ArticleDOI
Three-dimensional echocardiographic evaluation of the right ventricle in patients with uncomplicated systemic lupus erythematosus.
A Buonauro,Regina Sorrentino,Roberta Esposito,Liliana Nappi,Antonio Lobasso,Ciro Santoro,Felice Rivellese,V Sellitto,Francesca Wanda Rossi,Bianca Liccardo,Antonella Tufano,Maurizio Galderisi,A de Paulis +12 more
TL;DR: A subclinical RV systolic dysfunction is detectable in SLE by 3DE, RV lateral wall strain being a key parameter, and RV dysfunction is associated with cumulative disease damage.
Journal ArticleDOI
Local hyperactivation of L-type Ca2+ channels increases spontaneous Ca2+ release activity and cellular hypertrophy in right ventricular myocytes from heart failure rats.
Roman Y. Medvedev,Jose L. Sanchez-Alonso,Catherine Mansfield,Aleksandra Judina,Alice J. Francis,Christina Pagiatakis,Natalia A. Trayanova,Alexey V. Glukhov,Michele Miragoli,Giuseppe Faggian,Julia Gorelik +10 more
TL;DR: In this paper, the authors studied cellular mechanisms of RV remodelling in a rat model of left ventricle myocardial infarction (MI)-caused heart failure and found significant cellular hypertrophy accompanied with a disruption of transverse-axial tubular network and surface flattening.
Journal ArticleDOI
Pathophysiology, adaptation, and imaging of the right ventricle in Fontan circulation.
Matthew D. Files,Bhawna Arya +1 more
TL;DR: A complete review of RV adaptations as the RV assumes the role of the systemic ventricle, the progression of RV dysfunction to a distinct pattern of heart failure unique to this disease process, and the assessment and management strategies used to protect and rehabilitate the failing RV of Fontan circulation are provided.
Journal ArticleDOI
Decreased right ventricular lateral wall velocities early after cardiac surgery.
TL;DR: Tissue Doppler velocities of the RV free wall are reduced significantly after cardiac surgery despite no reduction in RV fractional area change.
Journal ArticleDOI
“Bionic Women and Men” Part 3: Right ventricular dysfunction in patients implanted with left ventricular assist devices
Manreet Kanwar,Barry J. McDonnell,Hannah Rosenblum,John R. Cockcroft,Eric J. Stöhr,Eric J. Stöhr,William K. Cornwell +6 more
TL;DR: This review highlights the anatomic and physiological peculiarities of the interplay between left and right heart function in patients undergoing LVAD therapy that would allow us to further advance the authors' understanding of right ventricular function.
References
More filters
Journal ArticleDOI
Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology.
Roberto M. Lang,Michelle Bierig,Richard B. Devereux,Frank A. Flachskampf,Elyse Foster,Patricia A. Pellikka,Michael H. Picard,Mary J. Roman,James B. Seward,Jack S. Shanewise,Scott D. Solomon,Kirk T. Spencer,Martin St. John Sutton,William J. Stewart +13 more
TL;DR: Members of the Chamber Quantification Writing Group are: Roberto M. Lang, MD, Fase, Michelle Bierig, MPH, RDCS, FASE, Richard B. Devereux,MD, Frank A. Flachskampf, MD and Elyse Foster, MD.
Journal ArticleDOI
ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease
Robert O. Bonow,Blase A. Carabello,Kanu Chatterjee,Antonio C. de Leon,David P. Faxon,Michael D. Freed,William H. Gaasch,Bruce W. Lytle,Rick A. Nishimura,Patrick T. O'Gara,Robert A. O'Rourke,Catherine M Otto,Pravin M. Shah,Jack S. Shanewise +13 more
TL;DR: It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management, and management of diseases.
Journal ArticleDOI
Survival in Patients with Primary Pulmonary Hypertension: Results from a National Prospective Registry
Gilbert E. D'Alonzo,Robyn J. Barst,Stephen M. Ayres,Edward H. Bergofsky,Bruce H. Brundage,Katherine M. Detre,Alfred P. Fishman,Roberta M. Goldring,Berton M. Groves,Janet T. Kernis,Paul S. Levy,Giuseppe G. Pietra,Lynne Reid,John T. Reeves,Stuart Rich,Carol E. Vreim,George W. Williams,Margaret Wu +17 more
TL;DR: Mortality was most closely associated with right ventricular hemodynamic function and can be characterized by means of an equation using three variables: mean pulmonary artery pressure, mean right atrial pressure, and cardiac index.
Journal ArticleDOI
Acute pulmonary embolism: clinical outcomes in the international cooperative pulmonary embolism registry (ICOPER)
TL;DR: Data from ICOPER provide rates and highlight adverse prognostic categories that will help in planning of future trials of high-risk PE patients and highlight significant prognostic factors associated with death.
Journal ArticleDOI
Clinical classification of pulmonary hypertension
Gérald Simonneau,Nazzareno Galiè,Lewis J. Rubin,David Langleben,Werner Seeger,Guido Domenighetti,Simon Gibbs,Didier Lebrec,Rudolf Speich,Maurice Beghetti,Stuart Rich,Alfred P. Fishman +11 more
TL;DR: The growth of understanding of the pulmonary hypertensive diseases that has enabled the development of a clinical classification oriented towards prevention and treatment is traced.
Related Papers (5)
Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure.
Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Roberto M. Lang,Luigi P. Badano,Victor Mor-Avi,Jonathan Afilalo,Anderson C. Armstrong,Laura Ernande,Frank A. Flachskampf,Elyse Foster,Steven A. Goldstein,Tatiana Kuznetsova,Patrizio Lancellotti,Denisa Muraru,Michael H. Picard,Ernst Rietzschel,Lawrence G. Rudski,Kirk T. Spencer,Wendy Tsang,Jens-Uwe Voigt +17 more