Right Ventricular Function and Failure

Voelkel, Norbert F.; Quaife, Robert A.; Leinwand, Leslie A.; Barst, Robyn J.; McGoon, Michael D.; Meldrum, Daniel R.; Dupuis, Jocelyn; Long, Carlin S.; Rubin, Lewis J.; Smart, Frank W.; Suzuki, Yuichiro; Gladwin, Mark T.; Denholm, Elizabeth M.; Gail, Dorothy B.

doi:10.1161/circulationaha.106.632208

Cited by 1,095 publications

(504 citation statements)

References 94 publications

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“…Recently, RV function has also been shown to have prognostic value in dogs with arrhythmogenic RV cardiomyopathy and myxomatous mitral valve disease 27, 28. Right ventricular dysfunction and dilatation in individuals with LV dysfunction can be explained by multiple independent or composite mechanisms including (1) pulmonary venous hypertension with subsequent “reactive” or “protective” pulmonary arterial hypertension; (2) the cardiomyopathic process simultaneously affecting both ventricles; (3) ischemic damage to both ventricles; (4) LV dysfunction that may affect RV coronary perfusion pressure, an important determinant of RV function; (5) ventricular interdependence caused by septal dysfunction; and (6) LV dilatation in a finite pericardial compartment that may hinder RV diastolic function 29, 30. Any one or some combination of these mechanisms may explain the changes in RV (and RA) size and function noted in our study.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic Assessment of Right Ventricular Size and Function in Cats With Hypertrophic Cardiomyopathy

Visser

Sloan

Stern

2017

Veterinary Internal Medicne

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BackgroundStudies evaluating right ventricular (RV) structural and functional abnormalities in feline hypertrophic cardiomyopathy (HCM) are limited.HypothesisRight ventricular structural and functional abnormalities are present in cats with HCM and are associated with clinical severity.AnimalsEighty‐one client‐owned cats.MethodsRetrospective 2‐dimensional (2D) echocardiographic study. Right atrial diameter (RAD), RV free wall thickness (RVFWd), RV internal dimension (RVIDd), RV fractional area change (FAC), and tricuspid annular plane systolic excursion (TAPSE) were measured in control cats (n = 26), cats with subclinical HCM (subclinical HCM; n = 31), and cats with HCM and congestive heart failure (HCM + CHF; n = 24).ResultsRight heart size (RAD, RVFWd, and RVIDd) and RV function (FAC and TAPSE) significantly (all P < .05) increased and decreased, respectively, in the HCM + CHF group compared with controls. In the subclinical HCM group, only RVFWd was significantly (P < .05) higher than in controls. Compared with reference intervals derived from controls, 29% of cats with HCM had increased RVFWd. Increased left ventricular free wall thickness, increased RVIDd and decreased TAPSE independently correlated with increased left atrial size. Cats with HCM and pleural effusion were significantly more likely to have increased RVFWd and had increased RAD and decreased TAPSE compared with cats without pleural effusion.Conclusions and Clinical ImportanceRight ventricular remodeling and dysfunction occur in some cats with HCM and may be associated with clinical severity. Our results support involvement of RV in the pathophysiology of HCM in some cats and support echocardiographic assessment of the RV in cats with HCM.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic Assessment of Right Ventricular Size and Function in Cats With Hypertrophic Cardiomyopathy

Visser

Sloan

Stern

2017

Veterinary Internal Medicne

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“…[17][18][19][20] CARDIAC ENERGY METABOLISM The heart has a very high energy demand, with more than 95% of this energy demand being met by adenosine triphosphate (ATP) derived from mitochondrial oxidative phosphorylation and the rest from glycolysis. 21,22 In an adult heart, 60%-90% of the ATP is derived from oxidation of fatty acids, whereas 10%-40% is generated from glucose oxidation (Fig.…”

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confidence: 99%

Cardiac Energy Metabolic Alterations in Pressure Overload–Induced Left and Right Heart Failure (2013 Grover Conference Series)

Sankaralingam

Lopaschuk

2015

Pulm. circ.

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Pressure overload of the heart, such as seen with pulmonary hypertension and/or systemic hypertension, can result in cardiac hypertrophy and the eventual development of heart failure. The development of hypertrophy and heart failure is accompanied by numerous molecular changes in the heart, including alterations in cardiac energy metabolism. Under normal conditions, the high energy (adenosine triphosphate [ATP]) demands of the heart are primarily provided by the mitochondrial oxidation of fatty acids, carbohydrates (glucose and lactate), and ketones. In contrast, the hypertrophied failing heart is energy deficient because of its inability to produce adequate amounts of ATP. This can be attributed to a reduction in mitochondrial oxidative metabolism, with the heart becoming more reliant on glycolysis as a source of ATP production. If glycolysis is uncoupled from glucose oxidation, a decrease in cardiac efficiency can occur, which can contribute to the severity of heart failure due to pressure-overload hypertrophy. These metabolic changes are accompanied by alterations in the enzymes that are involved in the regulation of fatty acid and carbohydrate metabolism. It is now becoming clear that optimizing both energy production and the source of energy production are potential targets for pharmacological intervention aimed at improving cardiac function in the hypertrophied failing heart. In this review, we will focus on what alterations in energy metabolism occur in pressure overload induced left and right heart failure. We will also discuss potential targets and pharmacological approaches that can be used to treat heart failure occurring secondary to pulmonary hypertension and/or systemic hypertension.

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“…Krivulja brzina protoka mjerenih tkivnim Dopplerom na lateralnom trikuspidnom anulusu [7]. Značajan napredak dijagnostičkih metoda omogućio je otvaranje novih perspektiva u proučavanju anatomije i fiziologije desne komore, ali zavisnost mjerenih parametara od punjenja desne komore čini evaluaciju i analizu njene funkcije posebno kompleksnom i izazovnom [8].…”

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Ehokardiografija u ranoj detekciji poremećaja funkcije desne komore pri promjeni volumena krvi kod bolesnika na hemodijalizi

Kovačevic-Preradović¹,

Vujisić-Tešić

Vlatković³

et al. 2017

Biomedicinska istraž.

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Uvod. Poremećaji funkcije desnog srca su prediktori loše prognoze kod pacijenata na programu hronične hemodijalize (HD). U ovoj studiji ispitivana je validnost ehokardiografije u procjeni sistolne i dijastolne funkcije desne komore kod pacijenata na HD.Metode. Istraživanjem je obuhvaćeno 30 pacijenata (55±11 godina) na hroničnoj HD kojima su rađene standardna 2D ehokardiografija i tkivni Doppler, prije i nakon HD.Rezultati. Ispitivanje sistolne funkcije desne komore prije i poslije HD je pokazalo da su frakciona promjena površine -FAC (36%±11 vs. 34%±11, p=0,464) i amplituda sistolne pokretljivosti anulusa trikuspidne valuvle -TAPSE (25,2mm±4,8 vs. 24,2mm±5, p=0,207) bile u granicama normalnih vrijednosti, nezavisno od smanjenja ukupnog volumena krvi nakon HD, dok je frakciono skraćenje -Fs (43,8%±11,6 vs. 39,3%±13,2, p=0,014) bilo značajno manje nakon HD, što pokazuje zavisnost ovog parametra od smanjenja cirkulatornog volumena. Tei indeks desne komore pokazao je normalne vrijednosti, nezavisno od smanjenja punjenja desne komore nakon HD (0,59±0,44 vs. 0,69±0,27, p=0,18). Evaluacija dijastolne funkcije desne komore preko brzina transtrikuspidnog protoka (E talas, E/A) pokazala je značajno smanjenje brzina nakon smanjenja volumena poslije HD, dok je odnos brzina E/E' (6,02±3,19 vs. 5,66±1,83, p=0,599) ostao u granicama normalnih vrijednosti i nakon HD.Zaključak. Ehokardiografska procjena sistolne funkcije desne komore pomoću FAC i TAPSE, kao i procjena globalne funkcije miokarda pomoću Tei indeksa, su pouzdane metode kod pacijenata na HD, pošto se njihove vrijednosti nisu mijenjale u uslovima smanjenja cirkulatornog volumena nakon HD. Kao pouzdan parametar za procjenu dijastolne funkcije kod pacijenata na HD se može koristiti odnos brzina E/E', koji se u ovom istraživanju nije značajno mijenjao usljed smanjenja volumena krvi nakon HD.Ključne riječi: funkcija desnog srca, hemodijaliza, Tei indeks, odnos E/E' Adresa autora: Doc. dr Tamara Kovačević-Preradović Ul. 12 beba bb,

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Right Ventricular Function and Failure

Cited by 1,095 publications

References 94 publications

Echocardiographic Assessment of Right Ventricular Size and Function in Cats With Hypertrophic Cardiomyopathy

Echocardiographic Assessment of Right Ventricular Size and Function in Cats With Hypertrophic Cardiomyopathy

Cardiac Energy Metabolic Alterations in Pressure Overload–Induced Left and Right Heart Failure (2013 Grover Conference Series)

Ehokardiografija u ranoj detekciji poremećaja funkcije desne komore pri promjeni volumena krvi kod bolesnika na hemodijalizi

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