日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

In pediatric cardiology, many situations require analysis of right ventricular function, but accurate measurement and evaluation of right ventricular function are not easy. The pathophysiology of right heart failure involves three mechanisms: pressure overload, volume overload, and myocardial dysfunction. In practice, however, these mechanisms often overlap to varying degrees. The most frequent and important cause of right ventricular dysfunction is pulmonary hypertension. Assessment of right ventricular dysfunction due to pulmonary hypertension may serve not only as a prognostic factor in this disease, but also as a baseline study that can be applied and inferred in other diseases. Thus, assessment of right ventricular dysfunction in pressure overload can serve as a pivotal study for universal analysis of right ventricular behavior.

In this review, we describe the structure and function of the normal right ventricle, followed by an explanation of the evaluation method of right ventricular dysfunction. We explain that right ventricular dysfunction includes not only changes in the contractile function of the right ventricle as a whole, but also impairments in contractile style, right ventricular-pulmonary coupling, synchrony, interventricular interaction, and diastolic capacity.