scholarly journals Asymmetry and Heterogeneity: Part and Parcel in Cardiac Autonomic Innervation and Function

2021 ◽  
Vol 12 ◽  
Author(s):  
Tjitske E. Zandstra ◽  
Robbert G. E. Notenboom ◽  
Jeroen Wink ◽  
Philippine Kiès ◽  
Hubert W. Vliegen ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Molecular Characteristics ◽  
Functional Heterogeneity ◽  
Adrenergic Stimulation ◽  
Adequate Treatment ◽  
Cardiac Autonomic Nervous System ◽  
Functional Studies ◽  
Left And Right ◽  
The Right ◽  
And Function

The cardiac autonomic nervous system (cANS) regulates cardiac adaptation to different demands. The heart is an asymmetrical organ, and in the selection of adequate treatment of cardiac diseases it may be relevant to take into account that the cANS also has sidedness as well as regional differences in anatomical, functional, and molecular characteristics. The left and right ventricles respond differently to adrenergic stimulation. Isoforms of nitric oxide synthase, which plays an important role in parasympathetic function, are also distributed asymmetrically across the heart. Treatment of cardiac disease heavily relies on affecting left-sided heart targets which are thought to apply to the right ventricle as well. Functional studies of the right ventricle have often been neglected. In addition, many principles have only been investigated in animals and not in humans. Anatomical and functional heterogeneity of the cANS in human tissue or subjects is highly valuable for understanding left- and right-sided cardiac pathology and for identifying novel treatment targets and modalities. Within this perspective, we aim to provide an overview and synthesis of anatomical and functional heterogeneity of the cANS in tissue or subjects, focusing on the human heart.

scholarly journals Dynamic pattern in the structural-functional parameters of the heart in children with myocardial pathology, taking into account morphological functional features of the right ventricle

2018 ◽  
pp. 32-36
Author(s):  
T. А. Holovko
Keyword(s):  
Left Ventricle ◽  
Right Ventricle ◽  
Children And Adolescents ◽  
Systolic Dysfunction ◽  
Structure And Function ◽  
Dynamic Pattern ◽  
Functional Features ◽  
The Right ◽  
And Function ◽  
Myocardial Pathology

The purpose of the study was to study the dynamics of changes in morphofunctional heart changes inchildren with non-inflammatory pathology of myocardium on the background of ongoing therapy. There were examined 115 patients (11–18 years old) with various heart diseases.The systolic dysfunction of the myocardium was diagnosedin 50 of them, and treatment was prescribed. In the dynamics, a year later, 40 patients were examined.  It has been established that in children and adolescents, along withpathogenetic and cardiometabolic therapy, in parallel with the improvement of the structure and function of the right ventricle of the heart, morphofunctional indicators ofthe left ventricle are improved.

scholarly journals Right Ventricle Involvement in Hypertrophic Cardiomyopathy and Role of Cardiac Magnetic Resonance in Hypertrophic Cardiomyopathy: Review Article

2021 ◽  
Vol 24 (4) ◽  
pp. E746-E750
Author(s):  
Weihao Ding ◽  
Sandeep Bhushan ◽  
Chen Ma ◽  
Yifan Yan ◽  
Zongwei Xiao
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Complex Geometry ◽  
Imaging Modality ◽  
Phenotypic Expression ◽  
The Right ◽  
And Function

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac disease, and its main characteristic is symmetrical or asymmetrical hypertrophy of the left ventricle and/or right ventricle. Most previous studies mainly include the left ventricle for definition of HCM, thus neglecting the right ventricle. But recently, many studies have reported the right ventricular involvement in HCM. Histopathological results showed that similar pathogenic changes in both the right and left ventricles, which suggests common myopathic processes and sarcomere genetic mutations. Cardiovascular magnetic resonance (CMR) is a gold standard imaging modality to assess heart anatomy and function and provides highly accurate and reproducible measurements. CMR is very useful in characterizing the various phenotypes of right and left ventricles in HCM. CMR also can be useful in detecting early and dominant phenotypic expression of HCM. Due to the complex geometry of the right ventricle and its retrosternal position, echocardiography may not provide accurate measurements. CMR also provides more accurate and repeatable right ventricular measurements. Thus, right ventricle evaluation along with left ventricle should routinely be done for better assessment of HCM patients.

End-systolic pressure length relations of stunned right and left ventricles after inotropic stimulation

1993 ◽  
Vol 265 (6) ◽  
pp. H2099-H2109 ◽  
Author(s):  
R. Krams ◽  
L. K. Soei ◽  
E. O. McFalls ◽  
E. A. Winkler Prins ◽  
L. M. Sassen ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Segment Length ◽  
Atrial Pacing ◽  
Regression Equations ◽  
External Work ◽  
Left And Right ◽  
The Right

Regional end-systolic pressure-segment length relationships (ESPSLR) were used to compare the degree of right and left ventricular stunning induced by a 10-min occlusion of the left anterior descending coronary artery and the response to subsequent atrial pacing (50 beats/min above intrinsic heart rate) without and with dobutamine (2 micrograms.kg-1.min-1) in nine anesthetized open-chest pigs. From the ESPSLR, the slope (Ees) (at 100 mmHg for the left and 25 mmHg for the right ventricle) and the total area of the pressure-length relationship (PLA) were determined. From the latter, the distribution into external work (EW) and potential energy (PE) as well as the efficiency of energy transfer (EET = EW/PLA) were calculated. In both the stunned left and right ventricular myocardium Ees and EW were reduced according to the same linear regression equations (delta Ees = 0.7 Ees,baseline - 11.4, r2 = 0.86 and delta EW = 0.4 EWbaseline + 2.3, r2 = 0.67), where Ees,baseline and EWbaseline are Ees and EW at baseline, respectively. EET of the stunned left and right ventricular segments decreased as PLA remained unchanged, due to an increase in PE. EET decreased from 0.84 +/- 0.02 to 0.71 +/- 0.03 (P < 0.05) in the stunned right ventricular segment and from 0.71 +/- 0.02 to 0.44 +/- 0.03 (P < 0.05) in the stunned left ventricular segment. Atrial pacing did not affect EET with respect to stunning levels, whereas the additional infusion of dobutamine restored Ees, EW, and PE and consequently EET to baseline values. In conclusion, the right ventricle is susceptible to stunning. During atrial pacing the EET was lower than expected from the Ees, which could, in agreement with the time-varying elastance concept, be explained by an increase in afterload (a consequence of the decrease in stroke volume). Dobutamine not only increased Ees, EW, and EET but also restored the relationship between Ees and EET in both ventricular stunned segments.

Ventricular pathology

2019 ◽  
pp. 243-270
Keyword(s):  
Coronary Ct Angiography ◽  
Cardiac Ct ◽  
Structure And Function ◽  
Coronary Ct ◽  
Left And Right ◽  
Myocardial Structure ◽  
Artery Disease ◽  
The Right ◽  
And Function ◽  
Cardiac Masses

Cardiac CT is most commonly performed for the evaluation of coronary artery disease in symptomatic patients. While abnormalities of myocardial structure and function are not common in patients undergoing coronary CT angiography, cardiac CT is a highly accurate test for abnormalities involving the right and left ventricles. Readers performing cardiac CT should be familiar with cardiomyopathies, as well as the appearance of cardiac masses. This chapter covers the assessment of the left and right ventricles, ventricular dysfunction, the CT appearance of cardiomyopathies, cardiac masses, and tumours (benign, malignant, and pseudo).

scholarly journals Changes of Left and Right Ventricle Mechanics and Function in Patients with End-Stage Renal Disease Undergoing Haemodialysis

Medicina ◽  
2018 ◽  
Vol 54 (5) ◽  
pp. 87 ◽  
Author(s):  
Eglė Tamulėnaitė ◽  
Rūta Žvirblytė ◽  
Rūta Ereminienė ◽  
Edita Žiginskienė ◽  
Eglė Ereminienė
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Right Ventricle ◽  
End Stage Renal Disease ◽  
Longitudinal Function ◽  
Left And Right ◽  
Lv Ejection Fraction ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function

Background and objectives: Chronic kidney disease (CKD) increases the risk of cardiovascular diseases even in its early stages and is associated with structural and functional cardiac abnormalities. The aim of this study was to use speckle-tracking echocardiography (STE) to evaluate left and right ventricle mechanics and function, markers of subclinical dysfunction in patients with end-stage renal disease (ESRD) undergoing haemodialysis. Methods: Patients with ESRD undergoing regular haemodialysis and with preserved left ventricle (LV) ejection fraction (EF) (n = 38) were enrolled in this retrospective study. The control group consisted of 32 age-matched persons with normal kidney function (glomerular filtration rate (GFR) >90 mL/min/1.73 m2 according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)). Conventional 2D echocardiography and STE were performed in all patients. Results: 70 individuals, 31 (44.29%) males and 39 (55.71%) females, were included in the study. There were no significant differences in age, sex and body surface area between the groups. LV end diastolic diameter did not differ between the groups, while LV myocardial mass index was higher in the group of patients on haemodialysis (111.64 ± 27.99 versus 84.21 ± 16.99, p < 0.001) and LV diastolic dysfunction (LVDD) was found in 31 (81.6%) patients of this group. LV global longitudinal strain (GLS) (−22.43 ± 2.71 versus −24.73 ± 2.03, p < 0.001) and LV global circumferential strain (GCS) at the mitral valve and papillary muscles levels (−18.73 ± 3.49 versus −21.67 ± 2.22, p < 0.001; −18.64 ± 2.75 versus −20.42 ± 2.38, p = 0.005, respectively) were significantly lower in haemodialysis group patients. The parameters of the right ventricle (RV) free wall longitudinal function including RV GLS (−22.63 ± 3.04 versus −25.45 ± 2.48, p < 0.001), were reduced in haemodialysis patients compared with the controls. However, RV fractional area change (FAC) did not differ between the groups (p = 0.19). Conclusion: Patients with ESRD and preserved LV ejection fraction undergoing haemodialysis had a higher prevalence of LVDD and impaired LV longitudinal and circumferential deformation indices, as well as reduced RV longitudinal function and deformation parameters compared with the age-matched healthy controls. STE helps to detect subclinical LV and RV dysfunction in chronic haemodialysis patients.

P1799Importance of the parietal band in normal subjects and in patients with repaired tetralogy of Fallot: the unknown muscle of the forgotten ventricle

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Nedaei ◽  
N G Vejlstrup ◽  
P L Madsen
Keyword(s):  
Right Ventricle ◽  
Tetralogy Of Fallot ◽  
Normal Subjects ◽  
Free Wall ◽  
Tricuspid Valve Regurgitation ◽  
Anatomical Studies ◽  
Repaired Tetralogy Of Fallot ◽  
The Right ◽  
And Function ◽  
Rv Function

Abstract Introduction The parietal band (PB) is little acknowledged. The PB traverses the basal part of the right ventricle (RV) with myocardial fibres circumscribing the inlet portion of the RV, anatomical studies suggest the PB may be of significant importance for RV contraction. RV dysfunction is of particular concern in patients with repaired Tetralogy of Fallot (ToF pts.). Purpose To study the importance of the PB for RV function in a retrospective cohort study by comparison of normal subjects with ToF pts. with and without resected PB. Methods The PB function was compared to RV volume and function by echocardiography and magnetic resonance imaging (CMR) in 89 normal subjects (echo and CMR) and 106 ToF pts. (CMR). Results A PB was identified in all normal subjects. In these, the PB shortened by 41±5% (mean±SD) during systole, and correspondingly, the septum-to-free wall distance was shortened by 47±17%. In ToF pts., the PB had been resected in 57.5% of cases. Resection of the PB was not of any consequence for RV dilatation or pulmonary and tricuspid valve regurgitation fraction (all ns), but resection was associated with a lowered RV free-wall to inter-ventricular septum approximation (21±13% vs. 39±9%) and consequently a lowered RV ejection fraction (RVEF; 45±8% vs. 54±8%) (both p<0.001). 84% vs. 48% (p<0.0001) had reduced RVEF if the PB had been resected. Conclusions The two groups of ToF pts. may differ in other aspects than presence of the parietal band, but taken together our findings in normal subjects and ToF pts. do suggest that the parietal band is significant importance for right ventricle contraction.

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