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
More filters
Journal ArticleDOI
Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography
Lawrence G. Rudski,Wyman W. Lai,Jonathan Afilalo,Lanqi Hua,Mark D. Handschumacher,Krishnaswamy Chandrasekaran,Scott D. Solomon,Eric K. Louie,Nelson B. Schiller +8 more
TL;DR: The Society of Echocardiography (SEDC) is an educational activity for cardiovascular physicians and cardiac sonographers with a knowledge base in the field of echo-cardiography as discussed by the authors.
Journal ArticleDOI
Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography
Lawrence G. Rudski,Wyman W. Lai,Jonathan Afilalo,Lanqi Hua,Mark D. Handschumacher,Krishnaswamy Chandrasekaran,Scott D. Solomon,Eric K. Louie,Nelson B. Schiller +8 more
TL;DR: This activity is designed for all cardiovascular physicians and cardiac sonographers with arest and knowledge base in the field of echocardiography and reschers, clinicians, intensivists, and other medical professionals with a spein cardiac ultrasound will find this activity beneficial.
Journal ArticleDOI
The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients
Maria Rosa Costanzo,Anne I. Dipchand,Randall C. Starling,Allen S. Anderson,Michael Chan,Shashank Desai,Savitri Fedson,Patrick W. Fisher,Gonzalo Gonzales-Stawinski,Luigi Martinelli,David C. McGiffin,Jon Smith,David O. Taylor,Bruno Meiser,Steven A. Webber,David A. Baran,Michael P. Carboni,Thomas J. Dengler,David L. Feldman,Maria Frigerio,Abdallah G. Kfoury,Daniel Kim,Jon A. Kobashigawa,Michael A. Shullo,Josef Stehlik,Jeffrey J. Teuteberg,Patricia A. Uber,Andreas Zuckermann,Sharon A. Hunt,Michael Burch,Geetha Bhat,Charles E. Canter,Richard E. Chinnock,Marisa G. Crespo-Leiro,Reynolds M. Delgado,Fabienne Dobbels,Kathleen L. Grady,W. Kao,Jaqueline Lamour,Gareth Parry,Jignesh Patel,Daniela Pini,Jeffrey A. Towbin,Gene Wolfel,Diego H. Delgado,Howard J. Eisen,Lee R. Goldberg,Jeff Hosenpud,Maryl R. Johnson,Anne Keogh,Clive Lewis,John B. O'Connell,Joseph G. Rogers,Heather J. Ross,Stuart D. Russell,Johan Vanhaecke,Amanda W. Rowe +56 more
TL;DR: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Starlings R: University of Chicago, Chicago, Illinois,USA; Chan M: university of Alberta, Edmonton, Alberta, Canada ; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA.
Journal ArticleDOI
Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council.
Leo Lopez,Steven D. Colan,Peter C. Frommelt,Gregory J. Ensing,Kathleen Kendall,Adel K. Younoszai,Wyman W. Lai,Tal Geva +7 more
TL;DR: This educational activity is designed for all cardiovascular physicians and cardiac sonographers with erest and knowledge base in the field of echocardiography; in addition, reschers, clinicians, intensivists, and other medical professionals with a cardiac ultrasound will find this activity beneficial.
Journal ArticleDOI
Pulmonary arterial hypertension
David Montani,Sven Günther,Peter Dorfmüller,Frédéric Perros,Barbara Girerd,Gilles Garcia,Xavier Jaïs,Laurent Savale,Elise Artaud-Macari,Laura C. Price,Marc Humbert,Gérald Simonneau,Olivier Sitbon +12 more
TL;DR: The current state of art regarding to epidemiologic aspects of PH, diagnostic approaches and the current classification of PH are discussed as well as future treatments.
References
More filters
Journal ArticleDOI
Predicting Fluid Responsiveness in ICU Patients: A Critical Analysis of the Evidence
TL;DR: In this article, the authors identified and critically reviewed the published peer-reviewed, English-language studies investigating predictive factors of fluid responsiveness in ICU patients and compared responder and nonresponder patients' characteristics before volume expansion.
Journal ArticleDOI
Regional Strain and Strain Rate Measurements by Cardiac Ultrasound: Principles, Implementation and Limitations
Jan D'hooge,Andreas Heimdal,Fadi Jamal,Tomasz Kukulski,Bart Bijnens,Frank Rademakers,Liv Hatle,Paul Suetens,George R. Sutherland +8 more
TL;DR: In this paper, a new ultrasonic method of quantifying regional deformation has been introduced based on the principles of "strain" and'strain rate' imaging, which introduces concepts derived from mechanical engineering which most echocardiographers are not familiar with.
Journal ArticleDOI
Doppler echocardiographic index for assessment of global right ventricular function
Chuwa Tei,Chuwa Tei,Karl S. Dujardin,Karl S. Dujardin,David O. Hodge,David O. Hodge,Kent R. Bailey,Kent R. Bailey,Michael D. McGoon,Michael D. McGoon,A. Jamil Tajik,A. Jamil Tajik,James B. Seward,James B. Seward +13 more
TL;DR: In this article, a Doppler-derived index, combining systolic and diastolic intervals of the right cycle, was used to assess global right ventricular function in patients with primary pulmonary hypertension.
Journal ArticleDOI
Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism.
TL;DR: When given in conjunction with heparin, alteplase can improve the clinical course of stable patients who have acute submassive pulmonary embolism and can prevent clinical deterioration requiring the escalation of treatment during the hospital stay.
Journal ArticleDOI
Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension
Ronald J. Raymond,Alan L. Hinderliter,Park W. Willis,David D. Ralph,Edgar J. Caldwell,William Williams,Neil A. Ettinger,Nicholas S. Hill,Warren R. Summer,Bennett De Boisblanc,Todd A. Schwartz,Gary G. Koch,Linda M. Clayton,Maria M. Jöbsis,James W. Crow,Walker Long +15 more
TL;DR: Pericardial effusion, right atrial enlargement and septal displacement are echocardiographic abnormalities that reflect the severity of right heart failure and predict adverse outcomes in patients with severe PPH.
Related Papers (5)
Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure.
Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Roberto M. Lang,Luigi P. Badano,Victor Mor-Avi,Jonathan Afilalo,Anderson C. Armstrong,Laura Ernande,Frank A. Flachskampf,Elyse Foster,Steven A. Goldstein,Tatiana Kuznetsova,Patrizio Lancellotti,Denisa Muraru,Michael H. Picard,Ernst Rietzschel,Lawrence G. Rudski,Kirk T. Spencer,Wendy Tsang,Jens-Uwe Voigt +17 more