Le Tourneau T, Piriou N, Donal E, Deswarte G, Topilsky Y, Lamblin N, Warin-Fresse K, Crochet D, Damy T, Trochu J N
Laboratoire d'Explorations Fonctionnelles, CHU, Nantes, France.
Minerva Cardioangiol. 2011 Aug;59(4):349-73.
The right ventricular function is difficult to assess owing to its complex morphology, structure and function. The right ventricle (RV) comprises three compartments, the inlet, the apex, and the outlet contracting with a peristaltic motion from the inflow to the outflow chamber and is tightly linked to left ventricular (LV) function through the pulmonary circulation, the interventricular septum and the myocardium inside the pericardial envelop. The relation of RV function to symptom occurrence, exercise capacity and prognosis in a wide variety of cardiac diseases emphasizes the usefulness of its routine assessment. The evaluation of the RV is largely carried out by echocardiography in daily clinical practice despite important limitations inherent to two-dimensional imaging. Multiple views and numerous parameters allow clinicians to integrate the RV function in the clinical decision-making process. Recent modalities of echocardiography such as myocardial deformation and three-dimensional imaging or exercise echocardiography are promising tools for the assessment of the RV. Cardiac magnetic resonance imaging provides the unique opportunity to image the RV in motion and in three dimensions without the limitation of echogenicity. Therefore, cardiac magnetic resonance imaging is taking a growing place in the assessment of the RV in a wide variety of cardio-pulmonary diseases as pulmonary hypertension, ischemia, arrhythmogenic right ventricular cardiomyopathy, hypertrophic cardiomyopathy, heart failure or congenital heart diseases. Integrating the complex interplay between both ventricles and the pulmonary circulation, this review will discuss the latest results of standard and novel techniques allowing the assessment of RV function by echocardiography and cardiac magnetic resonance imaging, and will provide to the clinicians, facing therapeutic challenges, a comprehensive overview of right heart function.
由于右心室复杂的形态、结构和功能，其功能难以评估。右心室由三个腔室组成，即流入道、心尖和流出道，它以蠕动运动从流入腔室向流出腔室收缩，并通过肺循环、室间隔和心包腔内的心肌与左心室功能紧密相连。在多种心脏疾病中，右心室功能与症状发生、运动能力及预后的关系凸显了对其进行常规评估的重要性。尽管二维成像存在重要局限性，但在日常临床实践中，右心室评估主要通过超声心动图进行。多个视图和众多参数使临床医生能够将右心室功能纳入临床决策过程。超声心动图的最新模式，如心肌变形和三维成像或运动超声心动图，是评估右心室的有前景的工具。心脏磁共振成像提供了在运动状态下对右心室进行三维成像的独特机会，且不受回声性的限制。因此，在多种心肺疾病，如肺动脉高压、缺血、致心律失常性右心室心肌病、肥厚型心肌病、心力衰竭或先天性心脏病中，心脏磁共振成像在右心室评估中所占的地位日益重要。综合两个心室与肺循环之间复杂的相互作用，本综述将讨论通过超声心动图和心脏磁共振成像评估右心室功能的标准技术和新技术的最新成果，并为面临治疗挑战的临床医生提供关于右心功能的全面概述。
