Cardiovascular Institute, University of Pittsburgh, Pennsylvania 15213, USA.
Curr Opin Crit Care. 2010 Jun;16(3):237-43. doi: 10.1097/MCC.0b013e3283382e58.
Pressure overload of the right ventricle results in right ventricular failure and death. Identifying right ventricular dysfunction at less severe stages, which would allow for more effective intervention, has been limited largely due to complex three-dimensional geometry, complex left ventricular/septum interactions, and lack of accepted approaches to assess regional and organ-level right ventricular function. There have been several recent approaches to better identifying right ventricular dysfunction. Recent advances, particularly in the field of pulmonary arterial hypertension, have highlighted the importance of the right ventricle and rekindled research interest to better understand its adaptation to pressure overload. This review focuses on advances in our understanding of right ventricular adaptation to pressure overload.
Advances in hemodynamic analysis and imaging the complex three-dimensional right ventricular shape continue to be reported. Additionally, several advances have occurred in our understanding of the pathophysiology of right ventricular adaptation to pressure overload.
Imaging and hemodynamic assessments may lead to better identification of right ventricular dysfunction and tools to follow response to treatment. Advances in pathophysiology are beginning to identify several novel treatments that may be of benefit to the failing right ventricle.
右心室的压力超负荷会导致右心衰竭和死亡。由于右心室的三维几何结构复杂、左心室/室间隔相互作用复杂以及缺乏公认的评估右心室局部和整体功能的方法,因此在病情不太严重的阶段识别右心室功能障碍并进行更有效的干预一直受到限制。目前已经有几种方法可以更好地识别右心室功能障碍。最近的进展,特别是在肺动脉高压领域,突出了右心室的重要性,并重新激发了研究兴趣,以更好地了解其对压力超负荷的适应。本文重点介绍了我们对右心室适应压力超负荷的理解的最新进展。
血流动力学分析和对复杂三维右心室形状的成像方面的进展仍在不断报道。此外,我们对右心室适应压力超负荷的病理生理学的理解也有了一些进展。
影像学和血流动力学评估可能有助于更好地识别右心室功能障碍,并为治疗反应提供监测工具。病理生理学的进展开始确定几种可能对衰竭的右心室有益的新疗法。