Echokardiografické hodnocení funkce pravé komory

Cor Vasa 2003, 44(10):492-500

Echocardiographic evaluation of right ventricular function

Jaroslav Meluzín^*, Martin Eisenberger: I. interní-kardioangiologická klinika, Fakultní nemocnice u sv. Anny a Lékařská fakulta Masarykovy univerzity, Brno, Česká republika

The aim of the study was to review current knowledge regarding the possibility of assessing right ventricular systolic and diastolic function by echocardiography. The right ventricle has a number of specific characteristics, which one must be familiar with and take into consideration when selecting the echocardiographic method and when interpreting the findings. These include the complex shape of the right ventricle, its marked trabeculization, major regional differences in the intensity of contraction and relaxation, and so on. At present, the most informative approach to echocardiographic right ventricular function evaluation seems to be assessment of its longitudinal function, which plays a key role in ejecting blood into the pulmonary bed. Right ventricular longitudinal function is best assessed by the extent or velocity of tricuspid annulus movement. Thanks to the advances made in tissue Doppler echocardiography, annular velocity measurement is today a very fast and available method for assessing right ventricular systolic and diastolic function. The clinical implications of evidence of right ventricular diastolic dysfunction are not fully understood. It can be used in the diagnosis of incipient stages of conditions affecting the right ventricle and to estimate an increase in right ventricular filling pressure. Evidence of systolic right ventricular dysfunction is of considerable clinical value in establishing the prognosis of acute pulmonary embolism, congestive heart failure with left ventricular dysfunction, and other conditions. Given the large number of diseases associated with right ventricular dysfunction, the importance of echocardiography in right ventricular function assessment is likely to grow as new echocardiographic methods become increasingly available and the specificity of their results is further improved.