Right ventricular mechanical pattern in health and disease: beyond longitudinal shortening.
Attila KovácsBálint LakatosMárton TokodiBéla MerkelyPublished in: Heart failure reviews (2020)
Right ventricular (RV) function has proven to be a prognostic factor in heart failure with reduced and preserved ejection fraction and in pulmonary hypertension. RV function is also a cornerstone in the management of novel clinical issues, such as mechanical circulatory support devices or grown-up congenital heart disease patients. Despite the notable amount of circumferentially oriented myofibers in the subepicardial layer of the RV myocardium, the non-longitudinal motion directions are often neglected in the everyday assessment of RV function by echocardiography. However, the complex RV contraction pattern incorporates different motion components along three anatomically relevant axes: longitudinal shortening with traction of the tricuspid annulus towards the apex, radial motion of free wall often referred as the "bellows effect", and anteroposterior shortening of the chamber by stretching the free wall over the septum. Advanced echocardiographic techniques, such as speckle-tracking and 3D echocardiography allow an in-depth characterization of RV mechanical pattern, providing better understanding of RV systolic and diastolic function. In our current review, we summarize the existing knowledge regarding RV mechanical adaptation to pressure- and/or volume-overloaded states and also other physiologic or pathologic conditions.
Keyphrases
- mycobacterium tuberculosis
- ejection fraction
- left ventricular
- pulmonary hypertension
- aortic stenosis
- heart failure
- prognostic factors
- congenital heart disease
- healthcare
- end stage renal disease
- blood pressure
- aortic valve
- computed tomography
- chronic kidney disease
- mitral valve
- mental health
- pulmonary artery
- left atrial
- newly diagnosed
- peritoneal dialysis
- lymph node
- high speed
- risk assessment
- optical coherence tomography
- transcatheter aortic valve replacement
- coronary artery disease
- health information
- atrial fibrillation
- patient reported outcomes
- rectal cancer
- radiation therapy
- locally advanced
- human health