Assessment of Right Ventricular Function

Abstract

In contrast to studies suggesting that the right ventricle (RV) often functions primarily as a conduit for blood flow from the venous circulation to the lungs, recent data show that the chamber plays a major role in maintenance of global cardiovascular homeostasis un der many conditions. Accordingly, clinicians involved with the perioperative care of surgical patients must be familiar with factors influencing RV performance. Com prised of two embryologically distinct regions, the inflow and outflow tracts, the crescent-shaped RV exhib its characteristics of filling and contraction that are different from those of the left ventricle (LV). Further more, although the basic determinants of ventricular function (rate and rhythm, preload, afterload, and con tractility) are the same for both the LV and RV, the relative contribution of each determinant to overall function of each chamber is somewhat different. This review approaches assessment of RV function from two directions. First, the anatomic and physiological differ ences between the RV and LV are described and used to show why some methods derived for complex character ization of LV function cannot be directly applied to the RV. Second, the application and limitations of methods used for perioperative assessment of RV function are discussed.