Axell Richard G, Hoole Stephen P, Hampton-Till James, White Paul A
Medical Physics and Clinical Engineering, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK,
Heart Fail Rev. 2015 May;20(3):363-73. doi: 10.1007/s10741-015-9472-0.
Right ventricular (RV) diastolic dysfunction was first reported as an indicator for the assessment of ventricular dysfunction in heart failure a little over two decades ago. However, the underlying mechanisms and precise role of RV diastolic dysfunction in heart failure remain poorly described. Complexities in the structure and function of the RV make the detailed assessment of the contractile performance challenging when compared to its left ventricular (LV) counterpart. LV dysfunction is known to directly affect patient outcome in heart failure. As such, the focus has therefore been on LV function. Nevertheless, a strategy for the diagnosis and assessment of RV diastolic dysfunction has not been established. Here, we review the different causal mechanisms underlying RV diastolic dysfunction, summarising the current assessment techniques used in a clinical environment. Finally, we explore the role of load-independent indices of RV contractility, derived from the conductance technique, to fully interrogate the RV and expand our knowledge and understanding of RV diastolic dysfunction. Accurate assessment of RV contractility may yield further important prognostic information that will benefit patients with diastolic heart failure.
右心室（RV）舒张功能障碍最早是在二十多年前被报道作为评估心力衰竭中心室功能障碍的一个指标。然而，RV舒张功能障碍在心力衰竭中的潜在机制和确切作用仍描述甚少。与左心室（LV）相比，RV结构和功能的复杂性使得对其收缩性能进行详细评估具有挑战性。已知LV功能障碍会直接影响心力衰竭患者的预后。因此，重点一直放在LV功能上。然而，尚未建立RV舒张功能障碍的诊断和评估策略。在此，我们回顾RV舒张功能障碍的不同因果机制，总结临床环境中使用的当前评估技术。最后，我们探讨源自电导技术的RV收缩性负荷独立指标的作用，以全面研究RV并扩展我们对RV舒张功能障碍的认识和理解。准确评估RV收缩性可能会产生进一步重要的预后信息，这将使舒张性心力衰竭患者受益。
