Understanding and recognition of the right ventricular function and dysfunction via a numerical study

Figures

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  Figure 1. Circulation model composed of: left ventricle (LV), systemic arteries, vascular bed, and veins, right ventricle (RV), right atrium (RA), pulmonary arteries, bed, and veins, left atrium (LA) and heart valves (▸).

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  Figure 2. Hemodynamic waveforms of the healthy condition. (a) Pressures, (b) flows, and (c) pressure–volume (PV) loops. Subscripts: lv left ventricle, Ao aortic and arterial vessels, sr systemic vascular bed, rv right ventricle, PuA pulmonary arteries, pr pulmonary vascular bed, Aov aortic valve, Mv mitral valve, Pv pulmonary valve, Tv tricuspid valve. The LV presents with flow peaks which are higher than the RV, exhibiting an LV pressure almost 6 times greater than the RV estimated one, both having a stroke volume of about 80 mL.

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  Figure 3. Pressures and flows for a heartbeat in the dysfunctions. (a) Systolic dysfunction, (b) diastolic dysfunction, and (c) combined dysfunction. Pra, right atrium (RA) pressure (subscript 1); Prv, right ventricle (RV) pressure (subscript 2); PPuA, pulmonary arteries (PuA) pressure (subscript 3); QTv, tricuspid valve flow (subscript 4); QPv, pulmonary valve flow (subscript 5). Black solid line, healthy configuration (p = 0%); coloured lines; the corresponded degree of RV impairment, p, from 10 to 100%. Significant values of computed pressures and flows are reported in Table S2 of the Supplementary Information.

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  Figure 4. Pressure–volume loops for RV (subscript 1) and LV (subscript 2). (a) Systolic dysfunction; (b) diastolic dysfunction, and (c) combined systolic and diastolic dysfunction. Black solid line, healthy configuration (p = 0%); coloured lines; the corresponded degree of right ventricle (RV) impairment, p, from 10 to 100%.

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  Figure 5. Comparison at various rates of impairment between the different types of dysfunction (symbols) and in vivo reference data (grey area) for a healthy subject. □, systolic dysfunction, ∆, diastolic dysfunction, and ○, combined systolic and diastolic dysfunction. (a) CVP, mean pressure in the central veins and in vivo data53, (b) CI, cardiac index and in vivo data53, and EF, ejection fraction for (c) right ventricle (RV) (EFRV) and in vivo data59, and (d) left ventricle (LV) (EFLV) and in vivo data60.