Author + information
- Received September 5, 2017
- Revision received December 22, 2017
- Accepted January 25, 2018
- Published online May 7, 2018.
- Mark K. Friedberg, MD∗ ()
- Labatt Family Heart Center, The Hospital for Sick Children, and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- ↵∗Address for correspondence:
Dr. Mark K. Friedberg, The Labatt Family Heart Center, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
The impact of one ventricle on the adjacent ventricle plays a key role in cardiac function. Ventricular-ventricular interactions are based on the arrangement in-series of the circulation and common pericardium, interventricular septum, and myocardial tracts. Imaging, in particular echocardiography, plays a central role in characterizing these interactions through geometric indices, septal configuration and motion, Doppler flow, timing of events in the ventricles and alterations in strain, remodeling, and diastolic filling with altered loading of the contralateral ventricle. Although standard echocardiography techniques are usually adequate to image ventricular-ventricular interactions, recent developments in automation, post-processing, and advanced techniques (e.g., 3-dimensional) could improve detection and understanding of interventricular interactions. Imaging findings must be analyzed in the context of the pathophysiology to correctly assess and understand ventricular-ventricular interactions. This paper reviews the imaging of ventricular-ventricular interactions in acquired and congenital heart disease, demonstrating their importance in a wide array of conditions.
Dr. Friedberg has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received September 5, 2017.
- Revision received December 22, 2017.
- Accepted January 25, 2018.
- 2018 American College of Cardiology Foundation
- Central Illustration
- Physiological Basis
- Imaging Septal Shift and Ventricular Volumes
- Differences in RV Pressure Versus Volume Loading
- Imaging Parameters of Septal Shift
- Impact of the Hypertensive RV on the LV
- Interactions During Ventricular Loading and Effects of Pulmonary Disease
- Timing RV Versus LV Events
- RV Hypertension Prolongs RV Systole, Impacting LV Diastole
- Impaired RV Diastole Worsens LV Filling
- Common Myocardial Tracts
- Clinical Implications of Contralateral Dysfunction
- Diastolic Myocardial Interactions
- Pericardial Contribution to Interventricular Dependence
- Summary: Can Ventricular-Ventricular Interactions Be Quantified by Imaging?