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
Isolated right ventricular dysfunction in patients with human immunodeficiency virus.
Marc A. Simon,Christopher D. Lacomis,M. Patricia George,Cathy Kessinger,Renee Weinman,Deborah McMahon,Mark T. Gladwin,Hunter C. Champion,Alison Morris +8 more
TL;DR: In this article, the authors evaluated the prevalence of right ventricular dysfunction in an outpatient HIV cohort and found that RV dysfunction in HIV-infected individuals may be a separate entity from global cardiomyopathy or pulmonary hypertension.
Journal ArticleDOI
Occult RV systolic dysfunction detected by CMR derived RV circumferential strain in patients with pectus excavatum.
Vien T. Truong,Candice Y. Li,Rebeccah L. Brown,Ryan A. Moore,Victor F. Garcia,Eric J. Crotty,Michael D. Taylor,Tam M. N. Ngo,Wojciech Mazur +8 more
TL;DR: Mid-cavity circumferential strain but not longitudinal strain is reduced in pectus excavatum patients and Basal circumFerential strain as well as apical circumferent strain were increased as compensatory mechanism for reduced mid-c Cavity circum ferential strain.
Journal ArticleDOI
Right Ventricular Function: Imaging Techniques
TL;DR: Many RV function indices have now been studied in large samples of healthy dogs, and studies suggest a clinical benefit to echocardiographic RV function assessment in dogs and cats.
Journal ArticleDOI
Contraction Patterns of the Right Ventricle Associated with Different Degrees of Left Ventricular Systolic Dysfunction
Elena Surkova,Attila Kovács,Márton Tokodi,Bálint Károly Lakatos,Béla Merkely,Denisa Muraru,Alessandro Ruocco,Gianfranco Parati,Luigi P. Badano +8 more
TL;DR: In this paper, the functional adaptation of the right ventricle (RV) to different degrees of left ventricular (LV) dysfunction remains to be clarified, and the authors sought to assess the changes in RV co...
Journal ArticleDOI
Pulmonary vascular mechanical consequences of ischemic heart failure and implications for right ventricular function
Jennifer L. Philip,Thomas M. Murphy,David A. Schreier,Sydney Stevens,Diana M. Tabima,Margie Albrecht,Andrea L. Frump,Timothy A. Hacker,Tim Lahm,Tim Lahm,Naomi C. Chesler +10 more
TL;DR: It is demonstrated that pulmonary fibrosis contributes to increased RV afterload and loss of RV contractility contributes to RV dysfunction, which are key pathologic features of human pulmonary hypertension-left heart failure and offers a robust platform for future investigations.
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