Determinants of right ventricular afterload (2013 Grover Conference series)

Ryan J. Tedford

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)211-219
Number of pages9
JournalPulmonary Circulation
Volume4
Issue number2
DOIs
StatePublished - Jun 1 2014

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Keywords

  • Afterload
  • Arterial compliance
  • Pulmonary hypertension
  • Pulmonary vascular resistance
  • Right ventricle

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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