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
Right ventricular protein expression profile in end-stage heart failure.
Yan Ru Su,Manuel Chiusa,Evan L. Brittain,Anna R. Hemnes,Tarek S. Absi,Chee Chew Lim,Thomas G. Di Salvo +6 more
TL;DR: Differences in contractile, cytoskeletal, metabolic, signaling, and survival pathways exist between the RV and the LV in HF and may be related to the underlying HF etiology and differential posttranscriptional regulation.
Journal ArticleDOI
Thermodilution-derived indices for assessment of left and right ventricular cardiac function in normal and impaired cardiac function.
Constantin Trepte,Volker Eichhorn,Sebastian Haas,Hans Peter Richter,Matthias S. Goepfert,Jens C Kubitz,Alwin E. Goetz,Daniel A. Reuter +7 more
TL;DR: Right ventricular ejection fraction, global ejections fraction, and cardiac function index enable detection of changes in load-independent, intrinsic cardiac contractility and reflect changes of contractile function caused by substantial decrease of preload, emphasizing the importance of assessing both cardiac contractiles function in coherence with cardiac preload.
Journal ArticleDOI
Apical traction: a novel visual echocardiographic parameter to predict survival in patients with pulmonary hypertension
Serkan Ünlü,Konstantinos Farsalinos,Koen Ameloot,Ana Maria Daraban,Agnieszka Ciarka,Marion Delcroix,Jens-Uwe Voigt +6 more
TL;DR: At occurs in RVs with impaired systolic function in PH patients and may serve as a new, easily to assess visual parameter to predict the outcome in these patients, which needs to be validated by prospective studies.
Journal ArticleDOI
Systemic hypertension and the right-sided cardiovascular system: a review of the available evidence.
TL;DR: Quite in contrast with the common and simplistic assumption of a separate behaviour of the two ventricles, the right-sided cardiovascular system is not immune to the effect of systemic hypertension, a concept whose clinical and pathophysiological implications require further studies.
Journal ArticleDOI
Heart failure with preserved ejection fraction: a forest of a variety of trees.
Amil M. Shah,Marc A. Pfeffer +1 more
TL;DR: This editorial refers to ‘Right heart dysfunction in heart failure with preserved ejection fraction’, by V. Melenovsky et al, to appropriately call the attention to the importance of RV dysfunction as a contributing mechanism.
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