Open AccessDeterminants of Right Ventricular Afterload (2013 Grover Conference Series)
Author(s) -
Tedford Ryan J.
Publication year - 2014
Publication title -
pulmonary circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.791
H-Index - 40
ISSN - 2045-8940
DOI - 10.1086/676020
Subject(s) - pulsatile flow , afterload , medicine , cardiology , contractility , hemodynamics , pulmonary artery , vascular resistance , compliance (psychology) , resistive touchscreen , stroke volume , cardiac output , blood pressure , heart rate , electrical engineering , engineering , psychology , social psychology
Right ventricular (RV) afterload consists of both resistive and capacitive (pulsatile) components. Total afterload can be measured directly with pulmonary artery input impedance spectra or estimated, either with lumped‐parameter modeling or by pressure‐volume analysis. However, the inverse, hyperbolic relationship between resistance and compliance in the lung would suggest that the pulsatile components are a predictable and constant proportion of the resistive load in most situations, meaning that total RV load can be estimated from mean resistive load alone. Exceptions include elevations in left atrial pressures and, to a lesser extent, chronic thromboembolic disease. The pulsatile components may also play a more significant role at normal or near‐normal pulmonary artery pressures. Measures of coupling between RV afterload and RV contractility may provide important information not apparent by other clinical and hemodynamic measures. Future research should be aimed at development of noninvasive measures of coupling.