The Evaluation of Right Ventricular Function in Man

Abstract

The role of the right ventricle (RV) in maintaining cardiovascular homeostasis is controversial. In the past, its role in maintaining cardiac output was considered minimal [1]. Similarly, it is difficult to study RV function, owing to inadequacies in modeling of the RV volume and pressure responses to interventions used to define its behavior [2]. Thus, RV function has been poorly studied. Recent advances in indicator dilution technology and nuclear cardiology have increased our understanding of the processes involved in many disease states associated with RV dysfunction [2]. These studies suggest that the RV is very important in maintaining cardiac output under conditions of increased pulmonary vascular resistance, pulmonary hypertension and when increased oxygen demand requires proportional increases in cardiac output. These conditions exist in a variety of diseases commonly seen in critically ill patients, such as chronic obstructive lung disease, acute hypoxemic respiratory failure, and traumatic shock states. Furthermore, new catheter technologies have increased the availability of measurements of RV pressures and volume at the bedside. These collective changes in our understanding of disease processes and in our ability to measure RV pressures and volume may lead to an improved management of the critically ill.