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(Circulation. 2008;117:1717-1731.)
© 2008 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Right Ventricular Function in Cardiovascular Disease, Part II

Pathophysiology, Clinical Importance, and Management of Right Ventricular Failure

François Haddad, MD; Ramona Doyle, MD; Daniel J. Murphy, MD; Sharon A. Hunt, MD

From the Division of Cardiovascular Medicine (F.H., S.A.H.), Medicine (R.D.), and Pediatrics (D.J.M.), Stanford University, Palo Alto, Calif.

Correspondence to François Haddad, MD, Division of Cardiovascular Medicine, Stanford University, 770 Welch Rd, Ste 400, Palo Alto, CA 94304–5715. E-mail fhaddad@cvmed.stanford.edu

Key Words: cardiomyopathy • heart defects, congenital • heart failure • heart ventricles • transplantation • pulmonary hypertension

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Right ventricular (RV) function may be impaired in pulmonary hypertension (PH), congenital heart disease (CHD), and coronary artery disease and in patients with left-sided heart failure (HF) or valvular heart disease. In recent years, many studies have demonstrated the prognostic value of RV function in cardiovascular disease. In the past, however, the importance of RV function has been underestimated. This perception originated from studies on open-pericardium dog models and from the observation that patients may survive without a functional subpulmonary RV (Fontan procedure). In the 1940s, studies using open-pericardium dog models showed that cauterization of the RV lateral wall did not result in a decrease in cardiac output or an increase in systemic venous pressure.^1–3 As was later demonstrated, the open-pericardium model did not take into account the complex nature of ventricular interaction. In 1982, Goldstein and colleagues² showed that RV myocardial infarction (RVMI) in a closed-chest dog model led to significant hemodynamic compromise. These findings were further supported by clinical studies demonstrating an increased risk of death, arrhythmia, and shock in patients with RVMI.⁴

The study of the RV is a relatively young field. In 2006, the National Heart, Lung, and Blood Institute identified RV physiology as a priority in cardiovascular research.⁵ The goal of this review is to present a clinical perspective on RV physiology and pathobiology. In the first article of the series, the anatomy, physiology, embryology, and assessment of the RV were discussed. In this second part, we discuss the pathophysiology, clinical importance, and management of . . . [Full Text of this Article]

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