The review focuses on the mechanism of ventricular interdependence, a frequently encountered phenomena, especially in critically ill patients. It is explained by the anatomy of the heart, with two ventricles sharing a common wall, the septum, and nested in an acutely inextensible envelope, the pericardium. In pathological situation, it results in abnormal movements of the interventricular septum driven by respiration, leading to abnormal filling of one or the other ventricle. Ventricular interdependence has several clinical applications and explains some situations of hemodynamic impairment, especially in situations of cardiac tamponade, severe acute asthma, right ventricular (RV) overload, or more simply, in case of positive pressure ventilation with underlying acute pulmonary hypertension. Ventricular interdependence can be monitored with pulmonary arterial catheter or echocardiography. Knowledge of this phenomena has very concrete clinical applications in the management of filling or in the prevention or treatment of RV overload.
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http://dx.doi.org/10.3389/fphys.2023.1232340 | DOI Listing |
J Magn Reson Imaging
December 2024
Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Background: In arrhythmogenic cardiomyopathy (ACM), left ventricle-dominant presentation has poorer outcomes than right-dominant presentation, suggesting that interventricular functional disparity might play a role in patients' prognosis. However, the prognostic impact of ventricular functional discordance in ACM patients remains unknown.
Purpose: To assess whether ventricular functional disparity measured as ventricular discordance index, defined as the ratio of right-ventricular ejection fraction (RVEF) to left-ventricular ejection fraction (LVEF), might reveal prognostic disparities between phenotypes and offer added risk stratification value.
J Heart Lung Transplant
December 2024
Department of Cardiology, Ospedale San Luca IRCCS Istituto Auxologico Italiano, Milano, Italy; Department of Management, Information and Production Engineering, University of Bergamo, Dalmine (BG), Italy.
Background: RV reserve has been linked to exercise capacity and prognosis in cardiopulmonary diseases. However, evidence in this setting is limited, due to the complex shape and load dependency of the RV. We sought to study right ventricular (RV) adaptation to exercise by simultaneous three-dimensional echocardiography (3DE) and right heart catheterization (RHC).
View Article and Find Full Text PDFJ Physiol
December 2024
University of Bordeaux, INSERM, CRCTB, U1045, Pessac, France.
The pericardium plays an important role in mechanical interactions between the right (RV) and left (LV) ventricles, referred to as ventricular interdependence. However, the exact mechanisms of its supportive role remain unknown. The present study aimed to evaluate specifically ventricular interdependence in a model of isolated biventricular working heart of large mammal, which is in absence of neurohormonal influence or series interactions, and to evaluate the impacts of intact pericardium on this phenomenon.
View Article and Find Full Text PDFBiomedicines
November 2024
Institute of Heart Diseases, Wroclaw Medical University, 50-376 Wroclaw, Poland.
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