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Pathophysiology of the Right Ventricle in Health and Disease: an Update by Khodr Tello; Robert Naeije; Frances de Man; Marco Guazzi is a Medicine article available to read on EtoBox.

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## Abstract The contribution of the right ventricle (RV) to cardiac output is negligible in normal resting conditions when pressures in the pulmonary circulation are low. However, the RV becomes relevant in healthy subjects during exercise and definitely so in patients with increased pulmonary artery pressures both at rest and during exercise. The adaptation of RV function to loading rests basically on an increased contractility. This is assessed by RV end-systolic elastance (Ees) to match afterload assessed by arterial elastance (Ea). The system has reserve as the Ees/Ea ratio or its imaging surrogate ejection fraction has to decrease by more than half, before the RV undergoes an increase in dimensions with eventual increase in filling pressures and systemic congestion. RV-arterial uncoupling is accompanied by an increase in diastolic elastance. Measurements of RV systolic function but also of diastolic function predict outcome in any cause pulmonary hypertension and heart failure with or without preserved left ventricular ejection fraction. Pathobiological changes in the overloaded RV include a combination of myocardial fibre hypertrophy, fibrosis and capillary rarefaction, a tit

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Author

Khodr Tello; Robert Naeije; Frances de Man; Marco Guazzi

Publisher

Oxford University Press (OUP)

Published

2023

Language

EN

Field

Medicine (Health Sciences)