Right ventricular function

Right ventricular function

Right ventricular function is less understood than the left ventricular function, mainly because the number of studies are lesser. There is an increasing recognition of the importance of right ventricular function in cardiovascular disease, though it still lags behind that of the left ventricle.

There are a lot of challenges in the quantitative assessment of right ventricular function. The anatomy and function of the right ventricle is complex. Right ventricle has an inlet or sinus portion and an outlet or conus portion in addition to the body. The right ventricular fibers have more longitudinal shortening than radial shortening. Interactions between the right ventricle and the left ventricle include a shared wall – the interventricular septum, mutually encircling epicardial fibers and a common pericardial space which causes restraint on the function of one chamber when the other is enlarged.

Right ventricular physiology is quite different from that of the left ventricle, though the output of both ventricles are equal in the absence of shunts. The right ventricle normally operates at a much lower pressure, pumping blood into the low resistance pulmonary circuit so that the external work of the right ventricle is only about one fourth of the left ventricle. Right ventricle functions more like a bellows and can give much output with less of shortening due to the low impedance of the normal pulmonary vasculature. Right ventricle is a very efficient pump with ejection beginning very early during the pressure rise and continuing well beyond the peak right ventricular pressure even as the pressure falls.

Reference

1. Redington AN. Right ventricular function. Cardiology Clinics. 2002;20:341-9.