Right ventricular mechanical pattern in health and disease: beyond longitudinal shortening

Attila Kovács, Bálint Lakatos, Márton Tokodi, B. Merkely

Research output: Contribution to journalReview article

Abstract

Right ventricular (RV) function has proven to be a prognostic factor in heart failure with reduced and preserved ejection fraction and in pulmonary hypertension. RV function is also a cornerstone in the management of novel clinical issues, such as mechanical circulatory support devices or grown-up congenital heart disease patients. Despite the notable amount of circumferentially oriented myofibers in the subepicardial layer of the RV myocardium, the non-longitudinal motion directions are often neglected in the everyday assessment of RV function by echocardiography. However, the complex RV contraction pattern incorporates different motion components along three anatomically relevant axes: longitudinal shortening with traction of the tricuspid annulus towards the apex, radial motion of free wall often referred as the “bellows effect”, and anteroposterior shortening of the chamber by stretching the free wall over the septum. Advanced echocardiographic techniques, such as speckle-tracking and 3D echocardiography allow an in-depth characterization of RV mechanical pattern, providing better understanding of RV systolic and diastolic function. In our current review, we summarize the existing knowledge regarding RV mechanical adaptation to pressure- and/or volume-overloaded states and also other physiologic or pathologic conditions.

Original languageEnglish
JournalHeart Failure Reviews
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Right Ventricular Function
Health
Three-Dimensional Echocardiography
Traction
Pulmonary Hypertension
Echocardiography
Heart Diseases
Myocardium
Heart Failure
Pressure
Equipment and Supplies

Keywords

  • 3D echocardiography
  • Heart failure
  • Pulmonary hypertension
  • Right ventricle
  • Speckle tracking

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Right ventricular mechanical pattern in health and disease : beyond longitudinal shortening. / Kovács, Attila; Lakatos, Bálint; Tokodi, Márton; Merkely, B.

In: Heart Failure Reviews, 01.01.2019.

Research output: Contribution to journalReview article

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