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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Identification of optimal reference genes for transcriptomic analyses in normal and diseased human heart.
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TL;DR: The overall most stable reference genes across different heart cavities and disease conditions were GAPDH, IPO8, POLR2A and PPIA, which should provide useful guidelines for reference gene selection in RT-qPCR studies in human heart.
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The myriad essential roles of microRNAs in cardiovascular homeostasis and disease
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EXPRESS: Right Heart in Pulmonary Hypertension: From Adaptation to Failure.
TL;DR: Therapies that target cell growth, cellular metabolism, oxidative stress, and myocyte regeneration are being tested preclinically and future research should include establishing novel RVF models based on existing models and characterizing alterations in cardiac excitation–contraction coupling during transition from adaptive RV to RVF.
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Clinical value of echocardiographic Doppler-derived right ventricular dp/dt in patients with pulmonary arterial hypertension
Koen Ameloot,Pieter-Jan Palmers,Alexander Van De Bruaene,Annelies Gerits,Werner Budts,Jens-Uwe Voigt,Marion Delcroix +6 more
TL;DR: A reduced baseline RV dp/dt is a clear indicator of poor outcome independent of TAPSE in patients with PAH/CTEPH.
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