Advertisement

Systolic and Diastolic Right Ventricular Dysfunction

  • Diana Morvey
  • Shashank Gupta
  • Anjali Chandra
  • Ernst R. von Schwarz
Chapter

Abstract

The right ventricle (RV) was often considered clinically insignificant owing to its less muscular structure and its restricted blood flow to a single organ system, the pulmonary system. These misconceptions have resulted in this chamber being understudied; and therefore, limited available research data. The truth is, both ventricles are highly dependent on each other for normal functioning of the cardiovascular system. Therefore, abnormalities in one ventricle adversely impact the function of the other. Recent research on RV implicated that the RV is an important contributor in cardiovascular diseases processes. Thus, this chapter tries to elucidate some of the importance of the RV and its contribution to right ventricular dysfunction.

Keywords

Right ventricle Systolic right ventricular dysfunction Diastolic right ventricular dysfunction Prevalence of right ventricular dysfunction Autoimmune Valvular disease 

References

  1. 1.
    Bassem SI. Right ventricular failure. EJ Cardiol Pract. 2016;14(32). https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-14/Right-ventricular-failure.
  2. 2.
    Voelkel NF, Quaife RA, Leinwand LA, Barst RJ, McGoon MD, Meldrum DR, et al. Right ventricular function and failure. Circulation. 2006;114:1883–91.  https://doi.org/10.1161/CIRCULATIONAHA.106.632208.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Haddad F, Doyle R, Murphy DJ, Hunt SA. The right ventricular function in cardiovascular disease, part II. Pathophysiology, clinical importance and mangement of right ventricular failures. Contemporary reviews in cardiovascular medicine. Circulation. 2008;117:1717–31.  https://doi.org/10.1161/CIRCULATIONAHA.107.653584.CrossRefGoogle Scholar
  4. 4.
    Lahm T, McCaslin CA, Wozniak TC, Ghumman W, Fadl YY, Obeidat OS, et al. Medical and surgical treatment of acute right ventricular failure. J Am Coll Cardiol. 2010;56(18):1435–46.  https://doi.org/10.1016/j.jacc.2010.05.046.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Ryan JJ, Tedford R. Diagnosing and treating the right ventricular function in cardiovascular disease. Curr Opin Cardiol. 2015;30(3):292–300.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Walker LA, Buttrick PM. The right ventricle: biologic insights and response to disease: updated. Curr Cardiol Rev. 2013;9(1):73–81.  https://doi.org/10.2174/157340313805076296.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Zong PI, Tune JD, Downey HF. Mechanisms of oxygen demand/supply balance in the right ventricle. Exp Biol Med (Maywood). 2005;230(8):507–19. https://www.ncbi.nlm.nih.gov/pubmed/16118400/.CrossRefGoogle Scholar
  8. 8.
    Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, part I. Anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117:1436–48. Retrieve from  https://doi.org/10.1161/CIRCULATIONAHA.107.653576.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Toyono M, Harada K, Tamura M, Yamamoto F, Takada G. Myocardial acceleration during isovolumic contraction as a new index of right ventricular contractile function and its relation to pulmonary regurgitation in patients after repair of tetralogy of Fallot. J Am Soc Echocardiogr. 2004;17(4):332–7.  https://doi.org/10.1016/j.echo.2003.12.022.CrossRefPubMedGoogle Scholar
  10. 10.
    Trivedi DV, Adhikari AS, Sarkar SS, Ruppel KM, Spudich JA. Hypertrophic cardiomyopathy and the myosin mesa: viewing an old disease in a new light. Biophys Rev. 2017.  https://doi.org/10.1007/s12551-017-0274-6.
  11. 11.
    Comarmond C, Cacoub P. Myocarditis in Auto-immune or auto-inflmmatory disease. Autoimmun Rev. 2017;16(8) 811–6. Retrieve from  https://doi.org/10.1016/j.autev.2017.05.021.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Reddy S, Bernstein D. Molecular mechanisms of right ventricular failure. Circulation. 2015;132(18):1734–42.  https://doi.org/10.1161/CIRCULATIONAHA.114.012975.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Ho SY, Nihoyannopoulos P. Anatomy, echocardiography, and normal right ventricular dimensions. Heart. 2006;92(Suppl 1):i2–i13.  https://doi.org/10.1136/hrt.2005.077875.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Garrison D, Memon J. Cor Pulmonale. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2017. Available from https://www.ncbi.nlm.nih.gov/books/NBK430739.
  15. 15.
    Reddy S, Zhao M, Fajardo G, Katnelson E, Spin JM, Bernstein D. Physiologic and molecular characterization of a murine model of right ventricular volume overload. Am J Physiol Heart Circ Physiol. 2013;304(10):H114–H1327.  https://doi.org/10.1152/ajpheart.00776.2012.CrossRefGoogle Scholar
  16. 16.
    Pinamonti B, Brun F, Mestroni L, Sinagra G. Arrhythmogenic right ventricular cardiomyopathy: from genetics to diagnostic and therapeutic challenges. World J Cardiol. 2014;6(12):1234–44.  https://doi.org/10.4330/wjc.v6.i12.1234.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Lemarié J, Huttin O, Girerd N, Mandry D, Juillière Y, Moulin F, Lemoine S, Beaumont M, Marie PY, Selton-Suty C. Usefulness of speckle-tracking imaging for right ventricular assessment after acute myocardial infarction: a magnetic resonance imaging/echocardiographic comparison within the relation between aldosterone and cardiac remodeling after myocardial infarction study. J Am Soc Echocardiogr. 2015;28(7):818–27.  https://doi.org/10.1016/j.echo.2015.02.019.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Schwarz ER, Dashti R. The clinical quandary of left and right ventricular diastolic dysfunction and diastolic heart failure. Cardiovasc J Afr. 2010;21(4):212–20.  https://doi.org/10.5830/CVJA-2010-018.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    DiLorenzo MP, Bhatt SM, Mercer-Rosa L. How best to assess right ventricular function by echocardiography. Cardiol Young. 2015;25(8):1473–81.Retrieve from  https://doi.org/10.1017/S1047951115002255.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Van der Laarse A, Cobbaert CM, Umar S. Stem and progenitor cell therapy for pulmonary arterial hypertension: effects on the right ventricle (2013 Grover Conference Series). Pulm Circ. 2015;5(1):73–80.  https://doi.org/10.1086/679701.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Meng S, Guo L, Li G. Early changes in right ventricular longitudinal function in chronic asymptomatic alcoholics revealed by two-dimensional speckle tracking echocardiography. Cardiovasc Ultrasound. 2015;14:16.  https://doi.org/10.1186/s12947-016-0058-3.CrossRefGoogle Scholar
  22. 22.
    Inamdar AA, Inamdar AC. Heart failure: diagnosis, management and utilization. J Clin Med. 2016;5(7):62.  https://doi.org/10.3390/jcm5070062.CrossRefPubMedCentralGoogle Scholar
  23. 23.
    Fayssoi A, Abasse S, Nardi O. Right ventricular assessment with echocardiography. Med Sci (Paris). 2009;25(5):513–8. Retrieve from  https://doi.org/10.1051/medsci/2009255513.CrossRefGoogle Scholar
  24. 24.
    Kossaify A. Echocardiographic assessment of the right ventricle, from the conventional approach to speckle tracking and three-dimensional imaging, and insights into the “right way” to explore the forgotten chamber. Clin Med Insights Cardiol. 2015;9:65–75.  https://doi.org/10.4137/CMC.S27462.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Schmid E, Hilberath JN, Blumenstock G, Shekar PS, Kling S, Shernan SK, Nowak-Machen M. Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy. Heart Lung Vessel. 2015;7(2):151–8.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Schattke S, Knebel F, Grohmann A, Dreger H, Kmezik F, Riemekasten G, Baumann G, Borges A. Early right ventricular systolic dysfunction in patients with systemic sclerosis without pulmonary hypertension: a Doppler tissue and speckle tracking echocardiography study. Cardiovasc Ultrasound. 2010;8:3.  https://doi.org/10.1186/1476-7120-8-3.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Jorstig S, Waldenborg M, Thunberg P. Right ventricular ejection fraction measurements using two-dimensional transthoracic echocardiography by applying an ellipsoid model. Cardiovasc Ultrasound. 2017;15:4.  https://doi.org/10.1186/s12947-017-009-5.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Rosenkranz S, Preston IR. Right heart catheterisation: best practice and pitfalls in pulmonary hypertension. Eur Respir Rev. 2015;24(138):642–52.  https://doi.org/10.1183/16000617.0062-2015.CrossRefPubMedGoogle Scholar
  29. 29.
    Skhiri M, Hunt SA, Denault AY, Haddad F. Evidence-based management of right heart failure: a systematic review of an empiric field. Rev Esp Cardiol. 2010;63(4):451–71. https://doi.org/10.1016/S1885-5857(10)70094-3.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Diana Morvey
    • 1
  • Shashank Gupta
    • 1
  • Anjali Chandra
    • 1
  • Ernst R. von Schwarz
    • 1
  1. 1.Heart Institute, Southern California HospitalCulver CityUSA

Personalised recommendations