Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 73, Issue 12, Pages 1463-1482Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2018.12.076
Keywords
pulmonary hypertension; right ventricle; right ventricular function
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There is increasing recognition of the crucial role of the right ventricle (RV) in determining functional status and prognosis in multiple conditions. The normal RV is anatomically and functionally different from the left ventricle, which precludes direct extrapolation of our knowledge of left-sided physiopathology to the right heart. RV adaptation is largely determined by the level of exposure to hemodynamic overload (both preload and afterload) as well as its intrinsic contractile function. These 3 processes (pressure overload, volume overload, and RV cardiomyopathy) are associated with distinct clinical course and therapeutic approach, although in reality they often coexist in various degrees. The close relationship between the RV and left ventricle (ventricular interdependence) and its coupling to the pulmonary circulation further modulate RV behavior in different clinical scenarios. In this review, the authors summarize current knowledge of RV anatomic, structural, metabolic, functional, and hemodynamic characteristics in both health and disease. (c) 2019 by the American College of Cardiology Foundation.
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