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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Journal ArticleDOI
Quantitative Assessment of Right Ventricular Volumes and Ejection Fraction in Patients with Left Ventricular Systolic Dysfunction by Real Time Three-Dimensional Echocardiography versus Cardiac Magnetic Resonance Imaging.
TL;DR: The aim of this study was to assess the accuracy and reproducibility of real time three‐dimensional echocardiographic (RT3DE) for the determination of right ventricular volumes and function in patients with left ventricular systolic dysfunction.
Journal ArticleDOI
The Incremental Value of Right Ventricular Size and Strain in the Risk Assessment of Right Heart Failure Post - Left Ventricular Assist Device Implantation.
Marie Aymami,Myriam Amsallem,Myriam Amsallem,Jackson Adams,Karim Sallam,Kegan J. Moneghetti,Matthew T. Wheeler,William Hiesinger,Jeffrey J. Teuteberg,Dana Weisshaar,Jean-Philippe Verhoye,Y. Joseph Woo,Richard Ha,Francois Haddad,Dipanjan Banerjee +14 more
TL;DR: RV end-diastolic and strain are complementary prognostic markers of RHF after LVAD implantation, and both RVLS and RVEDAI were incremental to validated risk scores (including the EUROMACS score) for early RHFafter LVAD.
Journal ArticleDOI
Management of Right Heart Failure in the Critically Ill
TL;DR: Right ventricular failure complicates several commonly encountered conditions in the intensive care unit and principles of treatment focus on reversal of the underlying cause, optimization of right ventricular preload and contractility, and reduction ofright ventricular afterload.
Echocardiographic Assessment of Right Ventricular Systolic Function in Conscious Healthy Dogs
TL;DR: Echocardiographic indices in healthy dogs tracked expected changes in RV systolic function following pimobendan and atenolol and warrant study in dogs with cardiovascular disease and found significant differences from baseline were attributed to drug treatment.
Journal ArticleDOI
Exercise testing can unmask right ventricular dysfunction in systemic sclerosis patients with normal resting pulmonary artery pressure
E. Chia,Edmund M.T. Lau,Edmund M.T. Lau,Wei Xuan,David S. Celermajer,David S. Celermajer,Liza Thomas,Liza Thomas +7 more
TL;DR: Exercise stress testing unmasks reduced RV contractile reserve in SSc patients with normal resting PAP, suggesting subclinical RV dysfunction during exercise may be a surrogate for early pulmonary vascular disease in S sc patients.
References
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