Understanding right ventricular dyssynchrony: Its myriad determinants and clinical relevance

Name: Work Video:
Duration: 3 min 30 s
Alan G. Fraser; Bart Bijnens; Mark K. Friedberg
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"'fibres',": [241], 'contracts': [244], 'health': [246], 'like': [248], 'pair': [250], 'bellows,': [252], 'piston-like': [256], 'LV,': [260], 'free': [263, 440, 497, 537, 674, 702, 1413], 'wall': [264, 472, 491, 538, 651, 675, 703, 748, 1171, 1227, 1240, 1281, 1288], 'deforming': [265], 'circumferentially': [266], 'towards': [267, 272, 337], 'septum': [269, 552, 720, 1410], 'longitudinally': [271], 'apex.': [274, 374], 'However,': [275], 'if': [276, 983, 1108], 'were': [280, 792, 832, 843, 880, 995, 1001], 'be': [282, 293, 299, 349, 487, 825, 1105, 1356, 1709], 'activated': [283, 434], 'instantaneously': [284], '(like': [285], 'LV),': [287], 'during': [289, 519, 1185, 1236], 'exercise,': [290], 'there': [291, 379, 443, 530, 708], 'would': [292, 298, 1353, 1372], 'risk': [295, 1439], 'blood': [297], 'trapped': [300], 'apex,': [303], 'thus': [304, 745], 'inducing': [305], 'an': [306, 619, 865, 906, 1051], 'important': [307, 452, 469, 1205], 'intra-cavitary': [308], 'gradient.': [310], 'That': [311, 1415], 'avoided,': [313], 'bloodstream': [316], 'guided': [318], 'efficiently': [319], 'from': [320, 351, 401, 919, 1153, 1394, 1477, 1527], 'inlet': [323, 339], 'outlet,': [326], 'contracting': [330], 'peristaltic': [333], 'way,': [334], 'moving': [335], 'initially': [336], 'base': [341], 'activating': [343], 'outlet': [345], 'last.': [346], 'can': [348, 1143, 1681], 'observed': [350, 518, 1619], 'traces,': [354], 'where': [355, 442, 489, 1520], 'small': [357], 'noticeable': [359], 'delay': [360], 'present': [362], 'between': [363, 431, 621, 943, 1523], 'contraction': [367, 533, 670, 698, 717, 916, 1311, 1320, 1404], 'basal': [369, 438, 655, 747], 'segments': [370, 656, 963, 985, 1018], 'In': [375, 494, 598, 629, 768], 'healthy': [377, 836], 'RV,': [378], 'little': [381], 'inhomogeneity': [382], '(Hui': [386, 936], '2010),': [389, 939], 'this': [393, 424, 599], 'becomes': [394], 'important.': [395], 'Delayed': [396], 'activation': [397, 1303], 'bundle': [403, 1243, 1260], 'branch': [404, 1244, 1261], 'block,': [405], 'such': [406, 1514], 'commonly': [408], 'occurs': [409], 'after': [410], 'repair': [411], 'tetralogy': [413, 1517], 'Fallot': [415], 'some': [418, 660, 710, 806, 828], 'other': [419, 1478], 'congenital': [420], 'heart': [421], 'exaggerates': [423], 'effect': [425, 1068], 'results': [427, 823, 1082, 1152], 'electromechanical': [429, 1021, 1388, 1533], 'dyssynchrony': [430, 615, 661, 763, 786, 978, 1022, 1059, 1071, 1133, 1348, 1389, 1488, 1534, 1645, 1687], 'early': [433, 445], 'wall,': [441, 498], 'stretching': [446], 'followed': [447], 'pronounced': [449], 'lengthening.': [450], 'An': [451], 'consequence': [453, 1277, 1445], 'curvature': [463, 1225, 1258], 'very': [465], 'heterogeneous.': [466], 'because': [470, 662, 969, 1170], 'stress,': [473], 'which': [474, 926, 1630], 'individual': [479], 'myocytes': [480], 'sense': [481], 'need': [483, 1354], 'overcome,': [485], 'will': [486, 590], 'higher': [488], 'flatter.': [493], 'balanced': [502], 'thickness': [505, 1172, 1228], 'myocyte': [508], 'orientation,': [509], 'consequence,': [513], 'differing': [514], 'responses': [516], 'afterload.': [522], 'For': [523], 'example,': [524], 'patients': [526, 1665], 'hypertension': [529, 1264, 1582], 'prolonged': [532], '(Dambrauskaite': [539], 'Interaction': [543], 'attributable': [544], 'pericardial': [546], 'constraint': [547], 'shared': [550], 'ventricular': [551, 849, 1162, 1644], 'tracts,': [555], 'means': [556], 'also': [561, 731, 1083, 1646], 'influenced': [562, 1049, 1189], 'LV': [564, 732, 1252], 'function,': [565, 1093], 'afterload': [566, 626, 1396], 'shape.': [568], 'balanced,': [573], 'synchronized': [574], 'optimized,': [576], 'whereas': [577, 1094], 'all': [578, 833, 1350, 1712, 1747], 'above': [581], 'determinants': [582], 'magnitude': [584], 'timing': [586, 1043], 'change': [591, 725], 'altered': [596, 1398], 'loading.': [597], 'issue': [600], 'Experimental': [602], 'Physiology,': [603], 'Ewalts': [604, 1009, 1450, 1621], 'al.': [606, 1011, 1452, 1623], '(2021)': [607, 1012, 1453, 1624], 'report': [608], 'degree': [611, 814], 'intraventricular': [614], 'interaction': [620, 1052, 1522], 'preload': [623, 686, 853, 1054, 1399], '(volume)': [624], '(PA': [627], 'pressure).': [628], 'first': [631], 'experiment,': [632], 'PA': [633, 772, 1500, 1581, 1611], 'was': [635, 687, 709, 764, 774, 787, 854, 885, 917, 949, 1493], 'increased': [636, 688, 743, 775, 1325, 1395], 'acutely': [637], 'modestly': [639], 'normobaric': [641], 'hypoxic': [642], 'vasoconstriction.': [644], 'Intraventricular': [645], 'systolic': [646, 944, 1334], 'increased,': [648, 788], 'disproportionally': [649], 'increasing': [650, 746, 757, 1070], 'stress': [652, 749, 1241, 1282], 'resulting': [658], 'prolongation': [664], 'peak': [669, 697, 716, 958, 1636], '(as': [676], 'explained': [677], 'Palau-Caballero': [679], '2017).': [682, 991, 1642], 'When,': [683], 'addition,': [685], 'exerting': [690], 'lower-body': [691], 'positive': [692], 'pressure,': [693], 'did': [704], 'change,': [706], 'increase': [711, 1460], '(presumably': [721], 'associated': [722, 1626], 'septal': [727], 'configuration': [728], 'and,': [729], 'perhaps,': [730], 'loading,': [733], 'reported).': [738], 'Additionally,': [739], 'size': [742], 'acutely,': [744], 'simultaneously': [751], 'invoking': [752], 'Frank–Starling': [754], 'mechanism': [755], 'development.': [760], 'Thus,': [761, 1669], 'reduced': [765, 812, 1073, 1078], '(Table': [766], '1).': [767], 'second': [770], 'study,': [771], 'sustained': [777], 'hypoxia': [778, 819], 'altitude.': [780, 1469], 'Compared': [781], 'baseline': [783], 'measurements,': [784], 'volumes': [791, 810, 877], 'reduced.': [793], 'Reversal': [794], 'depletion': [797], 'plasma': [799], 'volume': [800, 1525, 1556], 'rapid': [803], 'infusion': [804], 'saline': [807], 'restored': [808], 'dyssynchrony.': [817, 1560], 'Acute': [818], '(': [820], '12%)': [821], 'These': [822], 'should': [824, 1104], 'interpreted': [826], 'caution.': [829], 'subjects': [831], 'young': [834], 'volunteers,': [837], 'induced': [839], 'too': [844], 'transient': [845], 'produce': [847], 'chronic': [848, 1528], 'remodelling.': [850], 'estimated': [855, 886, 950], 'echocardiographic': [858], 'surrogate': [859], 'marker': [860], 'end-diastolic': [862, 1210, 1212, 1272, 1280, 1296], 'area': [863, 1213], 'apical': [866, 974, 984], 'four-chamber': [867], 'image,': [868], 'meaning': [869], 'explicitly': [882], 'measured.': [883], 'Afterload': [884], 'modified': [889], 'Bernoulli': [890], 'equation,': [891], 'tricuspid': [894], 'regurgitant': [895], 'velocity': [896, 934], 'diameter': [899], 'inferior': [902], 'caval': [903], 'vein': [904], 'approximate': [907], 'for': [909, 1673, 1711, 1744, 1751], 'atrial': [911], 'pressure.': [912], 'Timing': [913], 'measured': [918, 1013, 1106, 1634], 'strain': [920, 1027, 1086, 1095], 'curves': [921, 1028], 'obtained': [922], 'speckle': [924], 'tracking,': [925], 'has': [927, 1583], 'suboptimal': [928], 'temporal': [929, 1431], 'resolution': [930], 'imaging': [935, 1361], 'without': [941], 'discriminating': [942], 'post-systolic': [946], 'shortening.': [947], 'Dyssynchrony': [948], 'standard': [953], 'deviation': [954], 'times': [956], 'shortening': [959], 'only': [961, 1591], 'four': [962], '(two': [964], 'mid': [965], 'two': [967], 'basal)': [968], 'poor': [971], 'reproducibility': [972], 'segments,': [975], 'although': [976], 'accurately': [981], 'determined': [982, 1286, 1329], 'included': [987], '(Murata': [988, 1650], 'Some': [992], 'methodological': [993], 'compromises': [994], 'probably': [996], 'unavoidable,': [997], 'considering': [998], 'studies': [1000], 'performed': [1002], 'altitude,': [1004], 'they': [1006], 'mean': [1007, 1588], 'inhomogeneous': [1014], 'motion': [1015], 'rather': [1019, 1554], 'per': [1023], 'se.': [1024], 'illustrated': [1026], 'lack': [1029], 'detail.': [1030], 'Nonetheless,': [1031], 'general': [1033, 1141], 'conclusions': [1034, 1142], 'appear': [1035], 'valid': [1036], 'useful;': [1039], 'namely,': [1040], 'afterload,': [1056], 'making': [1057], 'both': [1060, 1386, 1542], 'load': [1061], 'dependent.': [1064], 'Presumably,': [1065], 'net': [1067], 'mechanical': [1075, 1392, 1418], 'efficiency': [1076, 1419], 'stroke': [1079], 'volume.': [1080, 1299], 'Their': [1081], 'confirm': [1084], 'load-dependent': [1089], 'index': [1090], 'rate': [1096, 1215], 'less': [1099], 'sensitive': [1100], 'instead': [1107], 'investigators': [1109, 1479], 'want': [1110], 'estimate': [1112], 'function.': [1115], 'A': [1116, 1265, 1442, 1506], 'recent': [1117], 'expert': [1118], 'consensus': [1119], 'concluded': [1120], "'further": [1122], 'insight': [1123], 'into': [1124], 'functional': [1126], 'significance': [1127], 'relevance': [1130], '[RV]': [1132], "needed'": [1135], '(Lahm': [1136], '2018).': [1139], 'What': [1140], 'we': [1144, 1680], 'draw?': [1145], 'Dyssnchrony': [1146], 'complex': [1149], 'phenomenon': [1150], 'interacting': [1155], 'factors': [1156, 1352], '(listed': [1157], 'Table': [1159], '2).': [1160], 'Right': [1161, 1242, 1643], 'diastolic': [1163], 'influences': [1165], 'stretch': [1168], 'inhomogeneously': [1169], 'stiffness': [1174], 'vary': [1175, 1184], 'sites.': [1178], 'Pulmonary': [1179, 1216], 'elastance': [1183], 'systole': [1186], 'cardiac': [1191, 1237], 'output.': [1192], 'Conduction': [1193], 'sequences': [1194], 'delays,': [1196], 'addition': [1198], 'variations': [1201], 'shape,': [1203], 'modulators.': [1206], 'Venous': [1207], 'return': [1208], 'volume/RV': [1211], 'Heart': [1214], 'pressure/compliance/pulmonary': [1218], 'vascular': [1219, 1598], 'resistance': [1220, 1599], 'Exercise': [1221], 'Local': [1222, 1226, 1239], 'radius': [1223, 1291], 'mass-to-volume': [1230], 'ratio': [1231], 'Change': [1232], 'cycle': [1238], 'block': [1245, 1262], 'Ischaemia': [1246], 'Cardiomyopathy': [1247], '(e.g.,': [1248], 'arrhythmogenic': [1249], 'cardiomyopathy)': [1251], '(diastolic': [1254], 'eccentricity': [1255], 'index)': [1256], 'Septal': [1257], 'Left': [1259], 'Systemic': [1263], 'unifying': [1266], 'hypothesis': [1267], "'preload'": [1270], 'sarcomeric': [1273], 'length': [1274], 'compliance,': [1285], 'thickness,': [1289], 'curvature,': [1293], 'Preload': [1300], 'heterogeneous': [1302], 'influence': [1304], 'duration': [1306], 'isovolumic': [1310], 'period': [1312], '(which': [1313, 1321], 'normally': [1315], 'short)': [1316], 'prolong': [1318], 'exaggerated': [1323], "'afterload'": [1326], 'mid-': [1331], 'late': [1333], 'relationship': [1337], 'shape)': [1340], '(Alkon': [1341], '2010).': [1344], 'To': [1345], 'understand': [1346, 1569], 'fully,': [1349], 'these': [1351, 1563], 'documented': [1357], 'studied.': [1359], 'Three-dimensional': [1360], '(by': [1362], 'echocardiography': [1363], 'magnetic': [1365], 'resonance': [1366], 'imaging)': [1367], 'invasive': [1369], 'haemodynamic': [1370], 'monitoring': [1371], 'provide': [1373], 'accurate': [1375], 'reliable': [1377, 1683], 'information,': [1378], 'when': [1379], 'feasible.': [1380], 'Although': [1381], 'aetiology': [1383], 'different,': [1385], 'dispersion': [1393, 1432], 'and/or': [1397], 'cause': [1400], 'patterns': [1402], 'work': [1407, 1716, 1732], 'wall.': [1414], 'reduces': [1416], 'fibrosis': [1423], 'dysfunction': [1425], '(Ebata': [1426], '2020).': [1429, 1505], 'maximal': [1434], 'strains': [1436], 'predicts': [1437, 1631, 1647], 'arrhythmias.': [1441], 'specific': [1443], 'study': [1448], 'supports': [1457], 'advice': [1458], 'fluid': [1461], 'intake': [1462], 'avoid': [1464], 'dehydration': [1465], 'while': [1466], 'acclimatizing': [1467], 'Confirmation': [1470], 'same': [1473, 1615], 'possible': [1474], 'explanation': [1475], 'comes': [1476], 'who': [1480, 1749], 'found': [1481], 'similar': [1482], 'effects': [1483], 'altitude': [1485], 'showed': [1490], 'correlated': [1494], 'oxygen': [1497, 1637], 'saturation': [1498], '(Yang': [1502], 'partial': [1507], 'parallel': [1509], 'might': [1510, 1565], 'occur': [1511], 'conditions': [1513], 'repaired': [1516], 'Fallot,': [1519], 'regurgitation': [1530], 'still': [1536], 'unclear': [1537], '(Lumens': [1538], '2019);': [1541], 'thought': [1544], 'contribute': [1546], 'adverse': [1548], 'outcomes,': [1553], "'correcting'": [1558], 'More': [1561], 'generally,': [1562], 'reflections': [1564], 'help': [1566], 'us': [1567], 'why,': [1570], 'basis': [1573], 'epidemiological': [1575], 'evidence,': [1576], 'recommended': [1578], 'definition': [1579], 'been': [1584], 'revised': [1585], '≥20': [1592], 'mmHg,': [1593], 'together': [1594], '≥3': [1601], 'Wood': [1602], 'units': [1603], '(Simonneau': [1604], '2019).': [1607], 'Modest': [1608], 'increases': [1609], 'order': [1616], 'dyssynchrony,': [1629], 'exercise': [1632], 'capacity': [1633], 'consumption': [1638], '(Badagliacca': [1639], 'deterioration': [1649], '2017)': [1653, 1663], 'survival': [1655], '(Cheng': 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'2024-12-12T10:53:09.653238', 'created_date': '2021-03-01'}
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