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J Am Coll Cardiol. 2019 Apr 2;73(12):1463-1482. doi: 10.1016/j.jacc.2018.12.076.

Anatomy, Function, and Dysfunction of the Right Ventricle: JACC State-of-the-Art Review.

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Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain. Electronic address:
Department of Anatomy and Cell Biology, Faculty of Medicine, University of Extremadura, Badajoz, Spain.
Cardiology Division, "A. Cardarelli" Hospital, Naples, Italy.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, Cardiovascular Sciences, Amsterdam, the Netherlands.
Department of Pathophysiology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.


There is increasing recognition of the crucial role of the right ventricle (RV) in determining functional status and prognosis in multiple conditions. The normal RV is anatomically and functionally different from the left ventricle, which precludes direct extrapolation of our knowledge of left-sided physiopathology to the right heart. RV adaptation is largely determined by the level of exposure to hemodynamic overload (both preload and afterload) as well as its intrinsic contractile function. These 3 processes (pressure overload, volume overload, and RV cardiomyopathy) are associated with distinct clinical course and therapeutic approach, although in reality they often coexist in various degrees. The close relationship between the RV and left ventricle (ventricular interdependence) and its coupling to the pulmonary circulation further modulate RV behavior in different clinical scenarios. In this review, the authors summarize current knowledge of RV anatomic, structural, metabolic, functional, and hemodynamic characteristics in both health and disease.


pulmonary hypertension; right ventricle; right ventricular function


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