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Journal of the American College of... Apr 2019There is increasing recognition of the crucial role of the right ventricle (RV) in determining functional status and prognosis in multiple conditions. The normal RV is... (Review)
Review
There is increasing recognition of the crucial role of the right ventricle (RV) in determining functional status and prognosis in multiple conditions. The normal RV is anatomically and functionally different from the left ventricle, which precludes direct extrapolation of our knowledge of left-sided physiopathology to the right heart. RV adaptation is largely determined by the level of exposure to hemodynamic overload (both preload and afterload) as well as its intrinsic contractile function. These 3 processes (pressure overload, volume overload, and RV cardiomyopathy) are associated with distinct clinical course and therapeutic approach, although in reality they often coexist in various degrees. The close relationship between the RV and left ventricle (ventricular interdependence) and its coupling to the pulmonary circulation further modulate RV behavior in different clinical scenarios. In this review, the authors summarize current knowledge of RV anatomic, structural, metabolic, functional, and hemodynamic characteristics in both health and disease.
Topics: Heart Ventricles; Hemodynamics; Humans; Hypertension, Pulmonary; Ventricular Dysfunction, Right; Ventricular Function, Right
PubMed: 30922478
DOI: 10.1016/j.jacc.2018.12.076 -
Indian Heart Journal 2018Takotsubo syndrome is a reversible acute heart failure frequently precipitated by an emotional or physical stress. The clinical presentation resembles acute coronary... (Review)
Review
Takotsubo syndrome is a reversible acute heart failure frequently precipitated by an emotional or physical stress. The clinical presentation resembles acute coronary syndrome. Pathogenesis is complex and may involve brain-heart axis and neuro-hormonal stunning of the myocardium. Coronary angiography reveals normal epicardial arteries with no obstruction or spasm. NT-ProBNP maybe remarkably elevated. Regional wall motion akinesia (RWMA) of left ventricle extends beyond the territory of one coronary artery. Reduced left ventricle ejection fraction (LVEF) and RWMA recover in 6-12 weeks. Prognosis is generally good. Recent meta-analysis shows in-hospital mortality of 1-4.5% and recurrence rate of 5-10% during five year follow-up.
Topics: Coronary Angiography; Electrocardiography; Heart Ventricles; Humans; Takotsubo Cardiomyopathy; Ventricular Function, Left
PubMed: 29455773
DOI: 10.1016/j.ihj.2017.09.005 -
Critical Care (London, England) Sep 2016The primary role of the right ventricle (RV) is to deliver all the blood it receives per beat into the pulmonary circulation without causing right atrial pressure to... (Review)
Review
The primary role of the right ventricle (RV) is to deliver all the blood it receives per beat into the pulmonary circulation without causing right atrial pressure to rise. To the extent that it also does not impede left ventricular (LV) filling, cardiac output responsiveness to increased metabolic demand is optimized. Since cardiac output is a function of metabolic demand of the body, during stress and exercise states the flow to the RV can vary widely. Also, instantaneous venous return varies widely for a constant cardiac output as ventilatory efforts alter the dynamic pressure gradient for venous return. Normally, blood flow varies with minimal changes in pulmonary arterial pressure. Similarly, RV filling normally occurs with minimal increases in right atrial pressure. When pulmonary vascular reserve is compromised RV ejection may also be compromised, increasing right atrial pressure and limiting maximal cardiac output. Acute increases in RV outflow resistance, as may occur with acute pulmonary embolism, will cause acute RV dilation and, by ventricular interdependence, markedly decreased LV diastolic compliance, rapidly spiraling to acute cardiogenic shock and death. Treatments include reversing the causes of pulmonary hypertension and sustaining mean arterial pressure higher than pulmonary artery pressure to maximal RV coronary blood flow. Chronic pulmonary hypertension induces progressive RV hypertrophy to match RV contractility to the increased pulmonary arterial elastance. Once fully developed, RV hypertrophy is associated with a sustained increase in right atrial pressure, impaired LV filling, and decreased exercise tolerance. Treatment focuses on pharmacologic therapies to selectively reduce pulmonary vasomotor tone and diuretics to minimize excessive RV dilation. Owning to the irreversible nature of most forms of pulmonary hypertension, when the pulmonary arterial elastance greatly exceeds the adaptive increase in RV systolic elastance, due to RV dilation, progressive pulmonary vascular obliteration, or both, end stage cor pulmonale ensues. If associated with cardiogenic shock, it can effectively be treated only by artificial ventricular support or lung transplantation. Knowing how the RV adapts to these stresses, its sign posts, and treatment options will greatly improve the bedside clinician's ability to diagnose and treat RV dysfunction.
Topics: Cardiac Output; Heart Ventricles; Humans; Hypertension, Pulmonary; Pulmonary Circulation; Ventricular Dysfunction, Right
PubMed: 27613549
DOI: 10.1186/s13054-016-1440-0 -
Journal of Anatomy Jan 2023The right ventricle (RV) is an important structure which serves a multitude of vital physiological functions in health. For many years, the left ventricle has dominated... (Review)
Review
The right ventricle (RV) is an important structure which serves a multitude of vital physiological functions in health. For many years, the left ventricle has dominated the focus of understanding in both biology and pathophysiology and the RV was felt to be more of a passive structure which rarely had an effect on disease states. However, it is increasingly recognised that the RV is essential to the homoeostasis of normal physiology and disturbances in RV structure and function have a substantial effect on patient outcomes. Indeed, the prognosis of diseases of lung diseases affecting the pulmonary vasculature and left heart disease is intimately linked to the function of the right ventricle. This review sets out to describe the developmental and anatomical complexities of the right ventricle while exploring the modern techniques employed to image and understand its function from a clinical perspective.
Topics: Humans; Heart Ventricles
PubMed: 35285014
DOI: 10.1111/joa.13654 -
Cardiology Journal 2010Double chambered is a term that has been used to describe the subdivision of a ventricle as a result of anomalous septum or muscle bundle. Subdivision of the left...
Double chambered is a term that has been used to describe the subdivision of a ventricle as a result of anomalous septum or muscle bundle. Subdivision of the left ventricular cavity is a rare cardiac anomaly compared to subdivision of the right ventricle. This case features a double chambered right ventricle and a rare double chambered left ventricle at the same time.
Topics: Adult; Echocardiography, Doppler; Heart Defects, Congenital; Heart Ventricles; Humans; Magnetic Resonance Imaging; Male
PubMed: 20535723
DOI: No ID Found -
Anesthesiology Jan 2019
Review
Topics: Echocardiography; Heart Defects, Congenital; Heart Ventricles; Humans
PubMed: 30192239
DOI: 10.1097/ALN.0000000000002438 -
Journal of the American Heart... Apr 2024
Topics: Humans; Prognosis; Heart Ventricles; Hypertension, Pulmonary; Ventricular Function, Right; Patients
PubMed: 38567674
DOI: 10.1161/JAHA.124.034711 -
Journal of the American College of... May 2022
Topics: Fontan Procedure; Heart Ventricles; Humans; Treatment Outcome; Tricuspid Valve; Tricuspid Valve Insufficiency
PubMed: 35331852
DOI: 10.1016/j.jacc.2022.03.003 -
JACC. Cardiovascular Imaging Dec 2021
Topics: Cardiac Resynchronization Therapy; Defibrillators, Implantable; Heart Ventricles; Humans; Predictive Value of Tests
PubMed: 34656463
DOI: 10.1016/j.jcmg.2021.07.024 -
Current Opinion in Cardiology May 2015Right ventricular failure (RVF) is associated with significant morbidity and mortality. There is an increasing interest in proper assessment of right ventricle (RV)... (Review)
Review
PURPOSE OF REVIEW
Right ventricular failure (RVF) is associated with significant morbidity and mortality. There is an increasing interest in proper assessment of right ventricle (RV) function as well as understanding mechanisms behind RVF.
RECENT FINDINGS
Within this article, we discuss the metabolic changes that occur in the RV in response to RVF, in particular, a shift toward glycolysis and increased glutaminolysis. We will detail the advances made in noninvasive imaging in assessing the function of the RV and review the methods to assess right ventricle-pulmonary artery coupling. We lastly investigate the role of new treatment options in the failing RV, such as β-blocker therapy.
SUMMARY
RVF is a complicated entity. Although some inferences on RV function and treatment can be made from our understanding of the left ventricle, the RV has unique features, anatomically, metabolically and embryologically, that require dedicated RV-directed research.
Topics: Adrenergic beta-Antagonists; Cardiac Catheterization; Echocardiography; Glucose; Glutamine; Glycolysis; Heart Failure; Heart Ventricles; Humans; Magnetic Resonance Imaging; Pulmonary Artery; Ventricular Dysfunction, Right
PubMed: 25807224
DOI: 10.1097/HCO.0000000000000164