Temporal Sequential Pattern of Right Ventricular Free Wall Contraction in Normal Children

Compared with the left ventricle (LV), the right ventricle (RV) is less suited for evaluation by echocardiography (ECHO). Nevertheless, RV ECHO-assessment has currently emerged as an important diagnostic tool with meaningful prognostic value and essential contribution to therapeutic decisions. Although significant progress has been made, including generation of higher-quality normative data, validation of several two-dimensional measurements and improvements in three-dimensional ECHO-techniques, many challenges in RV ECHO-assessment still persist. Areas covered: This review discusses the particular challenges and limits in obtaining accurate measurements of RV anatomical and functional parameters and focuses primarily on the difficulties in proper interpretation of the highly load dependent RV ECHO-parameters which complicates the use of this valuable diagnostic and surveillance technique. Expert commentary: There is increasing evidence that RV assessment in relation with its actual loading conditions by ECHO-derived composite variables, which either incorporate a certain functional parameter and load, or incorporate measures which reflect the relationship between RV dilation and RV load, considering also the right atrial pressure (i.e. 'load adaptation index'), is particularly suited for clinical decision-making. Load dependency of RV ECHO-parameters must be taken into consideration especially in patients with advanced RV dysfunction scheduled for LV assist device implantation or lung transplantation.

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Pathophysiology and Functional Assessment of Right Heart Failure

Hayabuchi

2021

Ped Cardiol Card Surg

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In pediatric cardiology, many situations require analysis of right ventricular function, but accurate measurement and evaluation of right ventricular function are not easy. e pathophysiology of right heart failure involves three mechanisms: pressure overload, volume overload, and myocardial dysfunction. In practice, however, these mechanisms o en overlap to varying degrees. e most frequent and important cause of right ventricular dysfunction is pulmonary hypertension. Assessment of right ventricular dysfunction due to pulmonary hypertension may serve not only as a prognostic factor in this disease, but also as a baseline study that can be applied and inferred in other diseases. us, assessment of right ventricular dysfunction in pressure overload can serve as a pivotal study for universal analysis of right ventricular behavior. In this review, we describe the structure and function of the normal right ventricle, followed by an explanation of the evaluation method of right ventricular dysfunction. We explain that right ventricular dysfunction includes not only changes in the contractile function of the right ventricle as a whole, but also impairments in contractile style, right ventricular-pulmonary coupling, synchrony, interventricular interaction, and diastolic capacity.

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Temporal Sequential Pattern of Right Ventricular Free Wall Contraction in Normal Children

Cited by 3 publications

References 28 publications

Ventricular systolic dysfunction with and without altered myocardial contractility: Clinical value of echocardiography for diagnosis and therapeutic decision-making

Ventricular systolic dysfunction with and without altered myocardial contractility: Clinical value of echocardiography for diagnosis and therapeutic decision-making

Evaluation of the right ventricle by echocardiography: particularities and major challenges

Pathophysiology and Functional Assessment of Right Heart Failure

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