Universität zu Köln

Sanders, Jason L., Koestenberger, Martin, Rosenkranz, Stephan and Maron, Bradley A. (2020). Right ventricular dysfunction and long-term risk of death. Cardiovisc. Diagn. Ther., 10 (5). S. 1646 - 1659. SHATIN: AME PUBL CO. ISSN 2223-3660

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Abstract

Sudden cardiac death (SCD), or sudden loss of life-sustaining systemic and cerebral perfusion, is most often due to left ventricular ( LV) dysfunction secondary to ischemic or structural cardiac disease or channelopathies. Degeneration of sinus rhythm into ventricular tachycardia and ultimately ventricular fibrillation is the final common pathway for most heart failure patients. Right ventricular (RV) dysfunction is recognized as an independent contributor to worsening heart failure. There is emerging evidence that RV dysfunction may also be an independent predictor of SCD. This review examines the role of RV dysfunction on modifying long term risk of SCD, and explores possible mechanisms that may underlie SCD. The RV has unique anatomy and physiology compared to the LV. Subsequently, we begin with a review of cardiac embryology, focusing on the chambers, valves, coronary arteries, and cardiac conduction system to understand the origins of RV dysfunction. Static and dynamic physiology of the RV is contrasted with that of the LV. Particular emphasis is placed on ventriculo-arterial coupling, mechanical cardiac constraint, and ventricular interdependence. The epidemiology of SCD is briefly reviewed to highlight how causes of SCD are age-specific. In turn, the age-specific causes of RV dysfunction are presented, including those which predominate in childhood and adolescence [arrhythmogenic RV dysplasia (ARVD) and hypertrophic cardiomyopathy (HCM)] and older adulthood (cardiac ischemia, chronic congestive heart failure and post-capillary pulmonary hypertension, and pulmonary hypertension). There is a clear need for additional studies on the independent contribution of RV dysfunction to overall functional capacity, SCD-associated mortality, and non-SCD-associated mortality. Discovery would be aided by the development of prospective cohorts with excellent RV phenotyping, coupled with deeper biologic measurements linking mechanisms to clinically relevant outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sanders, Jason L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koestenberger, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Maron, Bradley A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-316151
DOI:	10.21037/cdt-20-450
Journal or Publication Title:	Cardiovisc. Diagn. Ther.
Volume:	10
Number:	5
Page Range:	S. 1646 - 1659
Date:	2020
Publisher:	AME PUBL CO
Place of Publication:	SHATIN
ISSN:	2223-3660
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PULMONARY ARTERIAL-HYPERTENSION; CORONARY-HEART-DISEASE; HYPERTROPHIC CARDIOMYOPATHY; MYOCARDIAL-INFARCTION; SUDDEN-DEATH; FAILURE; FREQUENCY; STRATIFICATION; EPIDEMIOLOGY; INVOLVEMENT Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31615