Left ventricular contributions to right ventricular systolic function during LVAD support

Santamore, William P.; Gray, Laman A.

doi:10.1016/0003-4975(95)01056-4

Cited by 110 publications

(49 citation statements)

References 28 publications

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“…This alters the right ventricular compliance decreasing force and rate of contraction together with a decreased afterload and increased preload. In a healthy heart, cardiac output may be maintained but, with pre-existing pathology, the decrease in contractility may result in RVF [22]. It is therefore crucial to support right ventricular function during the first days following insertion of a left ventricular assist device.…”

Section: Ventricular Interdependencementioning

confidence: 99%

Acute right ventricular failure—from pathophysiology to new treatments

Mebazaa¹,

Kárpáti²,

Renaud³

et al. 2009

Applied Physiology in Intensive Care Medicine

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The right ventricle (RV) provides sustained low-pressure perfusion of the pulmonary vasculature, but is sensitive to changes in loading conditions and intrinsic contractility. Factors that affect right ventricular preload, afterload or left ventricular function can adversely influence the functioning of the RV, causing ischaemia and right ventricular failure (RVF). As RVF progresses, a pronounced tricuspid regurgitation further decreases cardiac output and worsens organ congestion. This can degenerate into an irreversible vicious cycle.The effective diagnosis of RVF is optimally performed by a combination of techniques including echocardiography and catheterisation, which can also be used to monitor treatment efficacy. Treatment of RVF focuses on alleviating congestion, improving right ventricular contractility and right coronary artery perfusion and reducing right ventricular afterload. As part of the treatment, inhaled nitric oxide or prostacyclin effectively reduces afterload by

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Section: Ventricular Interdependencementioning

confidence: 99%

Acute right ventricular failure—from pathophysiology to new treatments

Mebazaa¹,

Kárpáti²,

Renaud³

et al. 2009

Applied Physiology in Intensive Care Medicine

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“…In addition, systemic venous return increases. If RV systolic function is impaired, the net effect is RV enlargement, which decreases LV compliance and filling [43,44]. Biventricular systolic function is further compromised due to the altered position of the IVS at end diastole [2,3].…”

Section: Pulmonary Venous Hypertensionmentioning

confidence: 99%

Perioperative Management of Pulmonary Hypertension in Children with Critical Heart Disease

Bronicki

2011

Curr Treat Options Cardio Med

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Pulmonary hypertension (PHTN) is common to a variety of conditions occurring in infants and children presenting to the intensive care unit. A fundamental understanding of the response of the right ventricle to an increase in afterload and the clinical syndromes responsible for PHTN is essential for managing patients with PHTN and critical heart disease. There are important distinguishing features between PHTN syndromes, and although one form of PHTN may predominate, often more than one mechanism of PHTN is contributing to the pathophysiologic state. Thus, it is imperative to tailor therapies accordingly in order to optimize outcomes.

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“…Opposite, the contemporary augmented left output resulting in increased preload for the right heart sections can be detrimental in the presence of a compromised RV function which can rapidly decompensate [31]. The leftward septal shifts also favour RV dysfunction by reducing RV global contractility [32,33]. Nevertheless, because the LVAD output is strictly dependent on preload, a sufficient RV function must be warranted to avoid a low output syndrome due to LVAD low flow.…”

Section: Right Ventriclementioning

confidence: 99%