Stephanazzi J, Guidon-Attali C, Escarment J
Centre de traitement des brûlés (Dr Carsin), HIA Percy, Clamart, France.
Ann Fr Anesth Reanim. 1997;16(2):165-86. doi: 10.1016/s0750-7658(97)87197-3.
Sinus and conus constitute the two cavities of the right ventricle. They are anatomically and functionally different. The sinus is a flow-generator and the conus a pressure-regulator. The coronary circulation of the right ventricle is provided by the right coronary artery and the left anterior descending artery. The right ventricle is perfused during systole and diastole. When oxygen demand increases, coronary arteries dilate and oxygen extraction rises. As for the left ventricle, right ventricular performance depends upon heart rate, rhythm, contractility and loading conditions. Ventricular interactions are very important for right ventricular function. Loading conditions and contractility of the left ventricle are of major significance for right ventricular performance. For the right ventricle, the end of the ejection is different from the end of the active contraction. The time between them allows to achieve ventricular emptying. This duration is linked to afterload. Presently, it is impossible to accurately and simply assess these conditions. Pressure and volume overloadings result in right ventricular failure. They are responsible for ventricular dilation and ischaemia with a decrease in cardiac output, generating a vicious circle. Treatment includes the removal of the cause, and the maintenance of systemic arterial pressure and biventricular contractility. It is difficult to assess the effects of intravenous vasodilators on right ventricular afterload.
静脉窦和圆锥构成右心室的两个腔室。它们在解剖学和功能上有所不同。静脉窦是血流发生器，而圆锥是压力调节器。右心室的冠状动脉循环由右冠状动脉和左前降支动脉提供。右心室在收缩期和舒张期都有血液灌注。当氧需求增加时，冠状动脉扩张，氧摄取增加。与左心室一样，右心室的功能取决于心率、节律、收缩力和负荷情况。心室相互作用对右心室功能非常重要。左心室的负荷情况和收缩力对右心室功能具有重要意义。对于右心室而言，射血结束与主动收缩结束不同。两者之间的时间允许实现心室排空。这个持续时间与后负荷有关。目前，不可能准确且简单地评估这些情况。压力和容量超负荷会导致右心室衰竭。它们会导致心室扩张和缺血，心输出量减少，从而形成恶性循环。治疗包括消除病因，维持体循环动脉压和双心室收缩力。很难评估静脉血管扩张剂对右心室后负荷的影响。
