scholarly journals Right ventricular dysfunction and long-term risk of death

2020 ◽  
Vol 10 (5) ◽  
pp. 1646-1658
Author(s):  
Jason L. Sanders ◽  
Martin Koestenberger ◽  
Stephan Rosenkranz ◽  
Bradley A. Maron
Keyword(s):  
Right Ventricular ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Risk Of Death

scholarly journals Immediate and late impact of reperfusion therapies in acute pulmonary embolism

2019 ◽  
Vol 21 (Supplement_I) ◽  
pp. I1-I13 ◽  
Author(s):  
Luca Valerio ◽  
Frederikus A Klok ◽  
Stefano Barco
Keyword(s):  
Right Ventricular ◽  
Acute Pulmonary Embolism ◽  
Ventricular Dysfunction ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Right Ventricular Dysfunction ◽  
Haemodynamic Instability ◽  
Intermediate Risk ◽  
Systemic Thrombolysis ◽  
Thromboembolic Pulmonary Hypertension

Abstract Haemodynamic instability and right ventricular dysfunction are the key determinants of short-term prognosis in patients with acute pulmonary embolism (PE). Residual thrombi and persistent right ventricular dysfunction may contribute to post-PE functional impairment, and influence the risk of developing chronic thromboembolic pulmonary hypertension. Patients with haemodynamic instability at presentation (high-risk PE) require immediate primary reperfusion to relieve the obstruction in the pulmonary circulation and increase the chances of survival. Surgical removal of the thrombi or catheter-directed reperfusion strategies is alternatives in patients with contraindications to systemic thrombolysis. For haemodynamically stable patients with signs of right ventricular overload or dysfunction (intermediate-risk PE), systemic standard-dose thrombolysis is currently not recommended, because the risk of major bleeding associated with the treatment outweighs its benefits. In such cases, thrombolysis should be considered only as a rescue intervention if haemodynamic decompensation develops. Catheter-directed pharmaco-logical and pharmaco-mechanical techniques ensure swift recovery of echocardiographic and haemodynamic parameters and may be characterized by better safety profile than systemic thrombolysis. For survivors of acute PE, little is known on the effects of reperfusion therapies on the risk of chronic functional and haemodynamic impairment. In intermediate-risk PE patients, available data suggest that systemic thrombolysis may have little impact on long-term symptoms and functional limitation, echocardiographic parameters, and occurrence of chronic thromboembolic pulmonary hypertension. Ongoing and future interventional studies will clarify whether ‘safer’ reperfusion strategies may improve early clinical outcomes without increasing the risk of bleeding and contribute to reducing the burden of long-term complications after intermediate-risk PE.

scholarly journals P1535 Interventricular interaction can result in right ventricular dysfunction in interventricular septum involved myocardial infarction patient

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C S Park ◽  
A Gwon ◽  
H S Ahn ◽  
G H Kim ◽  
J S Cho ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Ventricular Dysfunction ◽  
Global Longitudinal Strain ◽  
Interventricular Septum ◽  
Right Ventricular Dysfunction ◽  
Free Wall ◽  
Right Ventricular Free Wall

Abstract Background Previous studies revealed that interventricular septal thickness is related to right ventricular dysfunction after anterior myocardial infarction. This finding suggest that interventricular septal function can affect right ventricular function in myocardial infarction patients. We assumed that right ventricular free wall strain values measured using dedicated software can be affected in the setting of ischemic insult on interventricular septum in long-term follow up. Methods The patients diagnosed as acute myocardial infarction due to left anterior descending artery disease who underwent successful revascularization were enrolled. Echocardiographic exams were performed at least 2 times, within 72 hours and 1 year after the revascularization. Strain values of interventricular septum and right ventricular free wall were derived from the raw-dicom images. The analysis was performed using the dedicated software for the measurement of right ventricular strain. Results Total 65 patients were enrolled. The values of global left ventricular strain were increased after the follow up. There were no changes in global longitudinal strain of the right ventricle. But longitudinal stain values acquired from right ventricular free walls were decreased even the strain values measured at left ventricle and interventricular septum were improved. Conclusion Interventricular septal dysfunction due to ischemic injury can affect long term right ventricular dysfunction. This finding suggests the interventricular dependence between cardiac chambers and can provide the development of heart failure in myocardial infarction patient even after the successful revascularization. Strain values of both ventricles Left ventricle after revascularization (n = 65) 1 year later (n = 65) P values Global longitudinal strain (%) -12.84 ± 4.50 -15.62 ± 4.45 <0.001 Septal longitudinal strain (%) -10.77 ± 5.96 -14.02 ± 5.26 <0.001 Right ventricle Global longitudinal strain (%) -19.36 ± 4.57 -19.47 ± 4.83 0.872 Septal longitudinal strain (%) -14.82 ± 4.48 -16.43 ± 6.03 0.055 Free wall longitudinal strain (%) -20.23 ± 5.33 -17.82 ± 5.70 0.010 Abstract P1535 Figure. Right ventricular segmental strain

scholarly journals Current outcomes and treatment of tetralogy of Fallot

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1530 ◽  
Author(s):  
Jelle P.G. van der Ven ◽  
Eva van den Bosch ◽  
Ad J.C.C. Bogers ◽  
Willem A. Helbing
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Dysfunction ◽  
Pulmonary Regurgitation ◽  
Treatment Strategies ◽  
Right Ventricular Dysfunction ◽  
Pulmonary Valve Replacement ◽  
Term Survival ◽  
The Right

Tetralogy of Fallot (ToF) is the most common type of cyanotic congenital heart disease. Since the first surgical repair in 1954, treatment has continuously improved. The treatment strategies currently used in the treatment of ToF result in excellent long-term survival (30 year survival ranges from 68.5% to 90.5%). However, residual problems such as right ventricular outflow tract obstruction, pulmonary regurgitation, and (ventricular) arrhythmia are common and often require re-interventions. Right ventricular dysfunction can be seen following longstanding pulmonary regurgitation and/or stenosis. Performing pulmonary valve replacement or relief of pulmonary stenosis before irreversible right ventricular dysfunction occurs is important, but determining the optimal timing of pulmonary valve replacement is challenging for several reasons. The biological mechanisms underlying dysfunction of the right ventricle as seen in longstanding pulmonary regurgitation are poorly understood. Different methods of assessing the right ventricle are used to predict impending dysfunction. The atrioventricular, ventriculo-arterial and interventricular interactions of the right ventricle play an important role in right ventricle performance, but are not fully elucidated. In this review we present a brief overview of the history of ToF, describe the treatment strategies currently used, and outline the long-term survival, residual lesions, and re-interventions following repair. We discuss important remaining challenges and present the current state of the art regarding these challenges.

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