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 Right Ventricle: Biologic Insights and Response to Disease: Updated
Lori A. Walker,Peter M. Buttrick +1 more
TL;DR: This review highlights some of the unique and distinguishing physiologic properties of the RV and underscores the fact that rational therapy in RV failure needs to acknowledge its unique physiology and ought to be chamber specific.
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Preoperative three-dimensional echocardiography to assess risk of right ventricular failure after left ventricular assist device surgery.
Michael S. Kiernan,Amy French,David DeNofrio,Yuvrajsinh J. Parmar,Duc Thinh Pham,Navin K. Kapur,Natesa G. Pandian,Ayan R. Patel +7 more
TL;DR: In this paper, the utility of 3-dimensional echocardiography (3DE) volumetric assessment to identify patients at risk for right ventricular failure (RVF) was examined.
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Right ventricular myocardial infarction: pathophysiology, diagnosis, and management
TL;DR: The diagnostic methods for RVMI are discussed, including clinical, electrocardiographic, and various imaging modalities as well as the RV pathophysiology that underpins the specifics of RVMI management.
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Assessment of the right ventricle with cardiovascular magnetic resonance at 7 Tesla
Florian von Knobelsdorff-Brenkenhoff,Florian von Knobelsdorff-Brenkenhoff,Valeriy Tkachenko,Valeriy Tkachenko,Lukas Winter,Jan Rieger,Christof Thalhammer,Fabian Hezel,Andreas Graessl,Matthias A Dieringer,Matthias A Dieringer,Thoralf Niendorf,Thoralf Niendorf,Jeanette Schulz-Menger,Jeanette Schulz-Menger +14 more
TL;DR: FGRE cine imaging of the RV at 7T was feasible and provided good image quality and RV dimensions and function were comparable to SSFP at 1.5T as gold standard.
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Echocardiographic Evaluation of the Right Ventricle: a 2014 Perspective
TL;DR: The current methods used in contemporary echocardiography laboratories are reviewed, with an emphasis on a guideline-based approach as well as emerging techniques.
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