Understanding and Recognition of the Right Ventricular Function and Dysfunction: A Numerical Study

Abstract The role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful validation against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.

Download Full-text

Understanding and recognition of the right ventricular function and dysfunction via a numerical study

Scientific Reports ◽

10.1038/s41598-021-82567-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Giulia Comunale ◽

Paolo Peruzzo ◽

Biagio Castaldi ◽

Renato Razzolini ◽

Giovanni Di Salvo ◽

...

Keyword(s):

Blood Pressure ◽

Right Ventricular ◽

Numerical Study ◽

Hemodynamic Parameters ◽

Right Heart ◽

Clinical Observations ◽

Lumped Parameter ◽

The Right ◽

First Time

AbstractThe role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful verification against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.

Download Full-text

Faculty Opinions recommendation of Shape of the right ventricular Doppler envelope predicts hemodynamics and right heart function in pulmonary hypertension.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.6136962.6174060 ◽

2010 ◽

Author(s):

Todd Bull ◽

Michael G Risbano

Keyword(s):

Pulmonary Hypertension ◽

Right Ventricular ◽

Heart Function ◽

Right Heart ◽

Right Heart Function ◽

The Right

Download Full-text

Age-changes in right ventricular function–pulmonary circulation coupling: from pediatric to adult stage in 1899 healthy subjects. The RIGHT Heart International NETwork (RIGHT-NET)

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-021-02330-z ◽

2021 ◽

Author(s):

Olga Vriz ◽

Gruschen Veldman ◽

Luna Gargani ◽

Francesco Ferrara ◽

Paolo Frumento ◽

...

Keyword(s):

Right Ventricular ◽

Ventricular Function ◽

Right Ventricular Function ◽

Pulmonary Circulation ◽

Healthy Subjects ◽

Adult Stage ◽

Age Changes ◽

Right Heart ◽

International Network ◽

The Right

Download Full-text

EXPRESS: Chronic thromboembolic pulmonary hypertension following pulmonary embolism with a right ventricular thrombus: A report of two cases

Pulmonary Circulation ◽

10.1177/20458940211013668 ◽

2021 ◽

pp. 204589402110136

Author(s):

Tailong Zhang ◽

Weitao Liang ◽

Longrong Bian ◽

Zhong Wu

Keyword(s):

Pulmonary Hypertension ◽

Right Ventricular ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Imaging Features ◽

Pulmonary Endarterectomy ◽

Right Heart ◽

Thromboembolic Pulmonary Hypertension ◽

The Right ◽

Cardiac Masses

Right heart thrombus (RHT) accompanied by chronic thromboembolic pulmonary hypertension (CTEPH) is a rare entity. RHT may develop in the peripheral veins or in situ within the right heart chambers. The diagnosis of RHT is challenging, since its symptoms are typically non-specific and its imaging features resemble those of cardiac masses. Here, we report two cases of RHT with CTEPH that presented as right ventricular masses initially. Both patients underwent simultaneous pulmonary endarterectomy (PEA) and resection of the ventricular thrombi. Thus, when mass-like features are confirmed by imaging, RHT should be suspected in patients with CTEPH, and simultaneous RHT resection is required along with PEA.

Download Full-text

Metastatic adenocarcinoma involving the right ventricle and pulmonary artery leading to right heart failure: case report

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2016.0351280117 ◽

2017 ◽

Vol 136 (3) ◽

pp. 262-265 ◽

Cited By ~ 1

Author(s):

Turgut Karabag ◽

Caner Arslan ◽

Turab Yakisan ◽

Aziz Vatan ◽

Duygu Sak

Keyword(s):

Heart Failure ◽

Case Report ◽

Pulmonary Artery ◽

Right Ventricle ◽

Right Ventricular ◽

Right Ventricular Outflow Tract ◽

Right Heart Failure ◽

Ventricular Outflow Tract ◽

Right Heart ◽

The Right

ABSTRACT CONTEXT: Obstruction of the right ventricular outflow tract due to metastatic disease is rare. Clinical recognition of cardiac metastatic tumors is rare and continues to present a diagnostic and therapeutic challenge. CASE REPORT: We present the case of a patient who had severe respiratory insufficiency and whose clinical examinations revealed a giant tumor mass extending from the right ventricle to the pulmonary artery. We discuss the diagnostic and therapeutic options. CONCLUSION: In patients presenting with acute right heart failure, right ventricular masses should be kept in mind. Transthoracic echocardiography appears to be the most easily available, noninvasive, cost-effective and useful technique in making the differential diagnosis.

Download Full-text

Dust related respiratory pathology and pulmonary hypertension

Russian Pulmonology ◽

10.18093/0869-0189-2008-0-4-77-80 ◽

2008 ◽

pp. 77-80

Author(s):

V. V. Razumov ◽

N. A. Shatskikh ◽

M. P. Zadorozhnaya

Keyword(s):

Arterial Hypertension ◽

Hemodynamic Parameters ◽

Left Heart ◽

Heart Ventricle ◽

Control Groups ◽

Right Heart ◽

Pulmonary Hemodynamics ◽

Initial Stage ◽

Respiratory Pathology ◽

The Right

Hemodynamic parameters of right and left heart ventricles and both greater and lesser blood circulations were studied using Doppler echocardiography in 129 patients with arterial hypertension, 54 patients with dust related respiratory pathology and 97 subjects of two control groups. Relying on the results we concluded that (1) the right heart ventricle and pulmonary circulation are targets for arterial hypertension, (2) pressure increase in arteries of lesser circulation occurs at the initial stage of dust related respiratory disease, (3) and the research of pulmonary hemodynamics with functional load should be obligatory when examining relationship between the disease and the profession.

Download Full-text

Bone Elastometric Measurements by Ultrasound Reflectometry: Observations on Physiology and Functional Organization of Bone

10.1115/imece2000-2283 ◽

2000 ◽

Author(s):

Shreefal S. Mehta ◽

Peter P. Antich ◽

Billy Smith ◽

Matthew A. Lewis ◽

Edmond Richer

Keyword(s):

Mechanical Properties ◽

Functional Organization ◽

Muscular Activity ◽

Diagnostic Techniques ◽

Rate Of Change ◽

Activity Levels ◽

Bone Material ◽

Clinical Observations ◽

First Time

Abstract Bone mechanical properties are strongly dependent on orientation and optimally adapted to the directional stresses induced by load bearing and muscular activity. Spatial and directional homogeneity and a slow rate of change of material mechanical properties are commonly assumed in the literature. The assumptions are based on limitations of widespread diagnostic techniques but are contradicted by results from several established techniques, including ultrasound reflectometry. A device based on the ultrasound reflectometry technique measures the mechanical elasticity of bone noninvasively at multiple sites and orientations, making it possible to carry out longitudinal studies at any chosen location in vivo. In vivo elastometric measurements over the length of a tibia were obtained with this device, demonstrating quantitatively for the first time the spatial and directional heterogeneity of bone material properties in vivo. Clinical observations made on two subjects also suggest that bone does exhibit rapid changes in response to altered activity levels.

Download Full-text

Right Heart Phenotype in Heart Failure With Preserved Ejection Fraction

Circulation Heart Failure ◽

10.1161/circheartfailure.120.007840 ◽

2021 ◽

Author(s):

Marco Guazzi ◽

Robert Naeije

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Right Ventricular ◽

Ventricular Dysfunction ◽

Imaging Techniques ◽

Treatment Options ◽

Right Ventricular Dysfunction ◽

Preserved Ejection Fraction ◽

Right Heart ◽

The Right

The health burden of heart failure with preserved ejection fraction is increasingly recognized. Despite improvements in diagnostic algorithms and established knowledge on the clinical trajectory, effective treatment options for heart failure with preserved ejection fraction remain limited, mainly because of the high mechanistic heterogeneity. Diagnostic scores, big data, and phenomapping categorization are proposed as key steps needed for progress. In the meantime, advancements in imaging techniques combined to high-fidelity pressure signaling analysis have uncovered right ventricular dysfunction as a mediator of heart failure with preserved ejection fraction progression and as major independent determinant of poor outcome. This review summarizes the current understanding of the pathophysiology of right ventricular dysfunction in heart failure with preserved ejection fraction covering the different right heart phenotypes and offering perspectives on new treatments targeting the right ventricle in its function and geometry.

Download Full-text

The Hemodynamic Characteristics of Right Ventricle After Gradient Pulmonary Artery Banding in Rats

10.21203/rs.3.rs-49641/v1 ◽

2020 ◽

Author(s):

Song Jiyang ◽

Wan Nan ◽

Shen Shutong ◽

Wei Ying ◽

Cao Yunshan

Keyword(s):

Heart Failure ◽

Pulmonary Artery ◽

Right Ventricle ◽

Right Ventricular ◽

Right Heart Failure ◽

Therapeutic Strategies ◽

Pulmonary Artery Banding ◽

Right Heart ◽

Pulmonary Arterial ◽

The Right

Abstract Background: Right ventricular (RV) failure induced by sustained pressure overload is a major contributor to morbidity and mortality in several cardiopulmonary disorders. Reliable and reproducible animal models of RV failure are important in order to investigate disease mechanisms and effects of potential therapeutic strategies. To establish a rat model of RV failure perfectly, we observed the right ventricle and carotid artery hemodynamics characteristics in different degrees of pulmonary artery banding of rats of different body weights. Methods: Rats were subjected to 6 groups：control(0%, n=5)(pulmonary arterial banding 0%), PAB(1-30%, n=4)(pulmonary arterial banding1-30%), PAB(31-60%, n=6)(pulmonary arterial banding31-60%),PAB(61-70%, n=5)(pulmonary arterial bandin61-70%), PAB(71-80%,n=4)(pulmonary arterial banding71-80%), PAB(100%, n=3)(pulmonary arterial banding 100%). We measured the right ventricular pressure(RVP) by right heart catheterization when the pulmonary arterial was ligated. Results: The RVP gradually increased with increasing degree of banding, but when occlusion level exceeding 70%, high pressure state can be only maintained for a few minutes or seconds, and then the RVP drops rapidly until it falls below the normal pressure, which in Group F particularly evident.Conclusions: RVP have different reactions when the occlusion level is not the same, and the extent of more than 70% ligation is a successful model of acute right heart failure. These results may have important consequences for therapeutic strategies to prevent acute right heart failure.

Download Full-text