Assessment of right ventricular function
Cardiac Resynchronization Therapy Devices
In contrast to studies suggesting that the right ventricle (RV) often functions primarily as a conduit for blood flow from the venous circulation to the lungs, recent data show that the chamber plays a major role in maintenance of global cardiovascular homeostasis under many conditions. Accordingly, clinicians involved with the perioperative care of surgical patients must be familiar with factors influencing RV performance. Comprised of two embryologically distinct regions, the inflow and outflow tracts, the crescent-shaped RV exhibits characteristics of filling and contraction that are different from those of the left ventricle (LV). Further more, although the basic determinants of ventricular function (rate and rhythm, preload, afterload, and contractility) are the same for both the LV and RV, the relative contribution of each determinant to overall function of each chamber is somewhat different. This review approaches assessment of RV function from two directions. First, the anatomic and physiological differences between the RV and LV are described and used to show why some methods derived for complex characterization of LV function cannot be directly applied to the RV. Second, the application and limitations of methods used for perioperative assessment of RV function are discussed. © 1997 by W B. Saunders Company.
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