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

Affiliation

Comunale G(1), Peruzzo P(2), Castaldi B(3), Razzolini R(4), Di Salvo G(3), Padalino MA(5), Susin FM(2).
Author information:
(1)Cardiovascular Fluid Dynamics Laboratory HER, Department of Civil, Environmental and Architectural Engineering, University of Padova, Via Loredan 20, 35131, Padova, Italy. [Email]
(2)Cardiovascular Fluid Dynamics Laboratory HER, Department of Civil, Environmental and Architectural Engineering, University of Padova, Via Loredan 20, 35131, Padova, Italy.
(3)Department of Women's and Children's Health, University of Padova Medical School, Padova, Italy.
(4)Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy.
(5)Paediatric and Congenital Cardiovascular Surgery Unit, Department of Cardio-Thoracic and Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy.

Abstract

The role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful verification against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.