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
Identifying the optimal regional predictor of right ventricular global function: a high-resolution three-dimensional cardiac magnetic resonance study
Timothy J W Dawes,A De Marvao,Wenzhe Shi,Daniel Rueckert,S A Cook,S A Cook,Declan P. O'Regan +6 more
TL;DR: It is concluded that systolic motion of the basal RV freewall predicts global function more accurately than other 2D estimators, however, no markers summarise 3D contractile patterns, limiting their predictive accuracy.
Journal ArticleDOI
Perioperative Considerations for Children With Right Ventricular Dysfunction and Failing Fontan
TL;DR: Perioperative assessment of patients with CHD and CHF, with an emphasis on pathophysiologic, diagnostic, and therapeutic alternatives in patients with right ventricular failure and failing Fontan circulation is focused on.
Journal ArticleDOI
Importance of End-Diastolic Rather than End-Systolic Right Atrial Size in Chronic Pulmonary Hypertension.
TL;DR: Right atrial (RA) enlargement has been associated with worse clinical outcomes in chronic pulmonary hypertension patients and there is paucity of information regarding the potential utility of RA dimensions obtained at the end of ventricular diastole.
Dissertation
Novel imaging techniques for assessing disease affecting the right heart
TL;DR: LV early diastolic wave velocities were the only independent predictors of functional capacity and clinical worsening in a model that includes conventional metrics of biventricular 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