Copyright © 1996 by the European Society of Cardiology.
© 1996 The European Society of Cardiology
Importance of the right ventricle in valvular heart disease
Cardiology, University Hospital Zürich, Switzerland
*Institute of Biomedical Engineering, Federal Institute of Technology Zürich, Switzerland
Received 24 July 1995; accepted 7 August 1995.
Correspondence: Otto M. Hess, MD, Cardiology, University Hospital, Rämistr. 100, 8091 Zurich, Switzerland
Abstract
The importance of the right ventricle as a determinant of clinical symptoms, exercise capacity, peri-operative survival and postoperative outcome has been underestimated for a long time. Right ventricular ejection fraction has been used as a measure of right ventricular function but has been found to be dependent on loading conditions, ventricular interaction as well as on myocardial structure. Altered left ventricular function in patients with valvular disease influences right ventricular performance mainly by changes in afterload but also by ventricular interaction. Right ventricular function and regional wall motion can be determined with right ventricular angiography, radionuclide ventriculography, two-dimensional echocardiography or magnetic resonance imaging. However, the complex structure of the right ventricle and its pronounced translational movements render quantification difficult. True regional wall motion analysis is, however, possible with myocardial tagging based on magnetic resonance techniques. With this technique a baso-apical shear motion of the right ventricle was observed which was enhanced in patients with aortic stenosis.
Key Words: Right ventricle • ventricular function • valve disease • pulmonary artery pressure • ventricular interaction • postoperative changes • myocardial tagging
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