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Right heart: the Monzino meets the challenge

The pathologies involving the right ventricular function have been at the center of an important scientific conference, headed by Prof. Piergiuseppe Agostoni, coordinator of the Critical Cardiology Area of Centro Cardiologico Monzino.

21 December Dec 2017 0000 5 months ago
  • Piergiuseppe Agostoni

The contribution of the right heart and, in particular, of the right ventricle to normal blood circulation has been for a log time considered "negligible", although, in 1616, Sir William Harvey had first described the importance of the function of the right ventricle (RV) , and several studies have now shown how the right ventricle is important from the diagnostic and prognostic point of view, not only for the diseases that affect it directly, but also for those affecting the left ventricle (LV).

With respect to the latter, the right ventricle (RV) has a greater sensitivity to the variations of the afterload and it is directly influenced by the venous and pulmonary physiology. Relatively modest changes in global pulmonary resistance lead to a reduction in contractile performance and in cardiac output. It's also thanks to this sensitivity to post-loading and to anatomical structural reasons that there is a close interrelation between the right and the left heart.

Right heart: a difficult challenge for the clinician

Right ventricular function can be compromised in many conditions, such as pulmonary hypertension, congenital heart disease, coronary heart disease, and in patients with left heart failure, as well as in valvular diseases.

Although the understanding of the physiological importance of RV on circulation has significantly increased over the last twenty years, the right heart (and its assessment) continues to be a challenge for the clinician. To meet this challenge, the Monzino Critical Cardiology Area, headed by professor Piergiuseppe Agostoni, brought together some of the most experienced specialists on the subject with the aim of setting out how to manage the clinical conditions of the half right of the heart. A CME, highly participated scientific conference "to get the ideas a little less obscure", as professor Agostoni said, on one of the most complex clinical problems in the management of cardiovascular diseases.

The importance of the time factor

During the conference, the study (invasive and non-invasive) of the right heart were discussed, with plenty of clinical cases and studies, triyng to answer the question that all clinicians ask themselves (or should ask themselves). : "What happens in the right heart and what to do, for example, in case of suspicion of increase of the tensile values ​​of the small circle, heart failure, orlung disease. With numerous insights into medical and surgical therapy and rehabilitation.

In the study of the right heart and in management of its dysfunction, every physician has to face a series of difficult challenges, expecially pathophysiological and technological one. Challenges that can be won and in wich the time factor plays an important role. The important thing is to know how to be interdisciplinary in the clinical evaluation, and to be able to rely on the operative structure of a third level Center, which promote this interdisciplinary nature, and on the cohesion of a specialized team that manages the patient.