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Function of the Left and Right Ventricles and the Interactions Between Them

Penny, Daniel J. MD, PhD, MHA1; Redington, Andrew N. MD2

Pediatric Critical Care Medicine: August 2016 - Volume 17 - Issue 8 - p S112-S118
doi: 10.1097/PCC.0000000000000794
Organ Systems: Cardiopathophysiology and Disorders

Objectives: There has been a recent increase in our understanding of mechanisms whereby the two sides of the heart interact and modulate each other that may be particularly relevant to patients in the ICU. For this review, our objectives are to examine the function of the left ventricle, consider some of the ways in which the function of the right ventricle differs from that of the left, and examine the effects of the left ventricle on the function of the right and vice versa.

Data Source: MEDLINE and PubMed.

Conclusions: There are fundamental differences between the function of the left and right ventricles, which relate to a significant extent to differences in their respective arterial loads. Although traditionally it has been usual to consider the function of the left and right ventricle in isolation, it is now recognized that this approach is flawed and as a result there is an increasing appreciation of the continual cross talk between the two sides of the heart in both the normal and diseased states. A more rational approach to the use of standard therapies frequently used in the cardiac ICU will come from a better understanding of these important fundamental concepts, and novel therapeutic concepts are already emerging from new data regarding biventricular interactions.

1Department of Pediatrics, Section of Cardiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX.

2Department of Pediatrics, Section of Cardiology, Cincinnati College of Medicine, Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

The authors have disclosed that they do not have any potential conflicts of interest.

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Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies