Mechanisms of Acute Right Ventricular Injury in Cardiothoracic Surgical and Critical Care Settings: Part 2
Author
Yusuff, HakeemChawla, Sanchit
Sato, Ryota
Dugar, Siddharth
Bangash, Mansoor N
Antonini, Marta Velia
Shelley, Benjamin
Valchanov, Kamen
Roscoe, Andrew
Scott, Jeffrey
Akhtar, Waqas
Rosenberg, Alex
Dimarakis, Ioannis
Khorsandi, Maziar
Zochios, Vasileios
Publication date
2023-07-23
Metadata
Show full item recordAbstract
The right ventricle (RV) is intricately linked in the clinical presentation of critical illness; however, the basis of this is not well-understood and has not been studied as extensively as the left ventricle. There has been an increased awareness of the need to understand how the RV is affected in different critical illness states. In addition, the increased use of point-of-care echocardiography in the critical care setting has allowed for earlier identification and monitoring of the RV in a patient who is critically ill. The first part of this review describes and characterizes the RV in different perioperative states. This second part of the review discusses and analyzes the complex pathophysiologic relationships between the RV and different critical care states. There is a lack of a universal RV injury definition because it represents a range of abnormal RV biomechanics and phenotypes. The term "RV injury" (RVI) has been used to describe a spectrum of presentations, which includes diastolic dysfunction (early injury), when the RV retains the ability to compensate, to RV failure (late or advanced injury). Understanding the mechanisms leading to functional 'uncoupling' between the RV and the pulmonary circulation may enable perioperative physicians, intensivists, and researchers to identify clinical phenotypes of RVI. This, consequently, may provide the opportunity to test RV-centric hypotheses and potentially individualize therapies.Citation
Yusuff H, Chawla S, Sato R, Dugar S, Bangash MN, Antonini MV, Shelley B, Valchanov K, Roscoe A, Scott J, Akhtar W, Rosenberg A, Dimarakis I, Khorsandi M, Zochios V; for Protecting the Right Ventricle Network (PRORVnet). Mechanisms of Acute Right Ventricular Injury in Cardiothoracic Surgical and Critical Care Settings: Part 2. J Cardiothorac Vasc Anesth. 2023 Nov;37(11):2318-2326. doi: 10.1053/j.jvca.2023.07.018. Epub 2023 Jul 23. PMID: 37625918.Type
ArticlePMID
37625918Publisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1053/j.jvca.2023.07.018