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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Characterization of Right Ventricular Deformation in Pulmonary Arterial Hypertension Using Three-Dimensional Principal Strain Analysis.
Alessandro Satriano,Payam Pournazari,Naushad Hirani,Doug Helmersen,Mitesh V. Thakrar,Jason Weatherald,James A. White,Nowell M. Fine +7 more
TL;DR: Three‐dimensional echocardiography provides comprehensive quantification of RV deformation and characterizes alterations occurring in PAH that are associated with WHO functional class.
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Prognostic Factors for Survival in Pulmonary Hypertension Due to Left Heart Disease
Sayuri Yamabe,Yoshihiro Dohi,Shinya Fujisaki,Akifumi Higashi,Hiroki Kinoshita,Yoshiharu Sada,Takayuki Hidaka,Satoshi Kurisu,Hideya Yamamoto,Yasuki Kihara +9 more
TL;DR: DPG is weakly associated with mortality in PH due to LHD and clinical factors such as NT-pro BNP, NYHA class, anemia and renal dysfunction are superior predictors.
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Comparison of positive end-expiratory pressure–induced increase in central venous pressure and passive leg raising to predict fluid responsiveness in patients with atrial fibrillation
TL;DR: A PEEP-induced increase in CVP did not predict fluid responsiveness in patients with atrial fibrillation after cardiac surgery, but increases in SVI during PLR seem to be a valid predictor of fluid responsive in this subset of patients.
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Role of echocardiography in the hemodynamic monitorization of critical patients
TL;DR: Some of the most important hemodynamic parameters that can be obtained at the patient bedside with transthoracic echocardiography in critically ill patients are described.
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Right ventricular ejection fraction <20% is an independent predictor of mortality but not of hospitalization in older systolic heart failure patients.
Philippe Meyer,Ravi V. Desai,Marjan Mujib,Margaret A. Feller,Chris Adamopoulos,Maciej Banach,Mitja Lainscak,Inmaculada Aban,Michel White,Wilbert S. Aronow,Prakash Deedwania,Prakash Deedwania,Ami E. Iskandrian,Ali Ahmed,Ali Ahmed +14 more
TL;DR: Abnormally low RVEF is a significant independent predictor of mortality, but not of HF hospitalization, in older adults with systolic HF.
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