Echocardiography in the assessment of right heart function

Abstract

Assessment of right heart function remains difficult despite rapid technological echocardiographic developments. This review addresses the anatomical and physiological basis for assessment of right ventricular function. It also addresses advantages and limitations of individual echocardiographic techniques currently used in clinical and academic practice. The review concludes that volume calculation and estimation of ejection fraction is not ideal for clinical assessment of right ventricular function. Regional myocardial wall motion detection by M-mode and tissue Doppler velocities are probably the best useful methods in clinical practice. 1D and 2D strain, velocity vector imaging and 4D echocardiography need further evaluation before considering them as routine investigations. A global interest needs to be given to a very important neglected entity, 'right ventricle', which has been shown to predict exercise tolerance and outcome in a number of syndromes.

Morphological and functional status of heart and large arteries in young individuals with unstable blood pressure

“…Если рассматривать эти изменения с точки зрения увеличения постна-грузки, то не совсем понятно, почему на неё реагируют правые отделы сердца при нормальном, неизменном ДЛА. Некоторые авторы [1,[5][6][7] объясняют это содру-жественной реакцией правого желудочка на стресс-воздействие в левом желудочке. Но нужно заметить, что у наших обследованных с ВНАД увеличивались КДО и КСО обоих желудочков без достоверных изме-нений толщины ЗС ЛЖ и МЖП и ММ ЛЖ.…”

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

“…Before the advent of TTE, studies of the RV largely focused on RVSP measurement via right heart catheterization, a terminal and invasive procedure 6,9,11,17 .…”

“…Numerous studies on LV structure and function using echocardiography have led to the establishment of normal values for LV structure and function 1,5,6 . Measurements of LV size and systolic function obtained from two-dimensional and Color Doppler images are of great importance as they allow visual delineation of compartments and geometry in great detail for the LV 7 .…”

“…However, echocardiographic evaluation of RV is inherently challenging due to its complex shape 5,11 and its retrosternal position that blocks the ultrasound waves 8,9 . RV is a crescent shaped structure wrapping around the LV and has a complex anatomy with thin walls that are accustomed to low pressure and resistance to pulmonary vasculature 6 . To overcome elevated vascular resistance (PVR), the RV first increases in size and undergoes hypertrophies.…”

Should thrombolysis have a greater role in the management of pulmonary embolism?

“…8 Physiologically, its mechanism of contraction is also complicated and not fully understood, with longitudinal and circumferential motion occurring. This makes assessment of its size and function using two-dimensional (2D) and M mode echocardiography less reliable than that of the left ventricle.…”