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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Ratio of Right to Left Ventricular Ejection: A Pilot Study Using Doppler to Detect Interventricular Dyssynchrony
TL;DR: Chronic pulmonary hypertension is known to delay maximal right ventricular deformation, causing mechanical dyssynchrony, but alterations between RV and left ventricular ejection should be easily identified during routine echocardiographic examinations.
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Comparison of Right Ventricular Function Between Patients With and Without Pulmonary Hypertension Owing to Left-Sided Heart Disease: Assessment Based on Right Ventricular Pressure-Volume Curves.
TL;DR: Although cardiac index was similar, RVSWI and RVMWI were significantly higher and SV/ESV was significantly lower in patients with PH because of LHD, suggesting that patients with postcapillary PH have inefficient RV performance.
Journal ArticleDOI
Diastolic function of the left and right ventricles of the heart in outpatients with arterial hypertension
TL;DR: The aim of the study is to investigate the impairment of diastolic function of the left ventricle and the right ventricles in arterial hypertension outpatients.
Journal ArticleDOI
Management of right ventricular dysfunction in the perioperative setting.
TL;DR: Management of acute right ventricular failure continues to be challenging because of the poor understanding of the pathophysiology, difficulties in diagnosing, the absence of guidelines, and limited therapeutic options.
Journal ArticleDOI
Mechanical Circulatory Support for Right Ventricular Failure
Ersilia M. DeFilippis,Veli K. Topkara,Ajay J. Kirtane,Koji Takeda,Yoshifumi Naka,Arthur R. Garan +5 more
TL;DR: The authors discuss the indications, candidate selection, strategies and outcomes of mechanical circulatory support for RV failure, including percutaneous and surgical mechanical support devices used for isolated RV failure.
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