Ventricle (heart)
Ventricle | |
---|---|
Details | |
Identifiers | |
Latin | ventriculus cordis |
MeSH | D006352 |
TA98 | A12.1.00.012 |
FMA | 7100 |
Anatomical terminology |
A ventricle is one of two large chambers located toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper heart that is smaller than a ventricle. Interventricular means between the ventricles (for example the interventricular septum), while intraventricular means within one ventricle (for example an intraventricular block).
In a four-chambered heart, such as that in
Structure
Ventricles have thicker walls than atria and generate higher blood pressures. The physiological load on the ventricles requiring pumping of blood throughout the body and lungs is much greater than the pressure generated by the atria to fill the ventricles. Further, the left ventricle has thicker walls than the right because it needs to pump blood to most of the body while the right ventricle fills only the lungs.[citation needed][1]
On the inner walls of the ventricles are irregular muscular columns called
The mass of the left ventricle, as estimated by magnetic resonance imaging, averages 143 g ± 38.4 g, with a range of 87–224 g.[2]
The right ventricle is equal in size to the left ventricle[
Its posterior wall is formed by the
Shape
The left ventricle is longer and more conical in shape than the right, and on transverse section its concavity presents an oval or nearly circular outline. It forms a small part of the sternocostal surface and a considerable part of the diaphragmatic surface of the heart; it also forms the apex of the heart. The left ventricle is thicker and more muscular than the right ventricle because it pumps blood at a higher pressure.
The right ventricle is triangular in shape and extends from the tricuspid valve in the right atrium to near the
Development
By early maturity, the walls of the left ventricle have thickened from three to six times greater than that of the right ventricle. This reflects the typical five times greater pressure workload this chamber performs while accepting blood returning from the pulmonary veins at ~80mmHg pressure (equivalent to around 11 kPa) and pushing it forward to the typical ~120mmHg pressure (around 16.3 kPa) in the aorta during each heartbeat. (The pressures stated are resting values and stated as relative to surrounding atmospheric which is the typical "0" reference pressure used in medicine.)
Function
During
The left ventricle receives oxygenated blood from the
The right ventricle receives deoxygenated blood from the right atrium via the tricuspid valve and pumps it into the pulmonary artery via the pulmonary valve, into the pulmonary circulation.
Pumping volume
The typical healthy adult heart pumping volume is ~5 liters/min, resting. Maximum capacity pumping volume extends from ~25 liters/min for non-athletes to as high as ~45 liters/min for Olympic level athletes.
Volumes
In cardiology, the performance of the ventricles are measured with several volumetric parameters, including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (Ef).
Ventricular volumes | ||
---|---|---|
Measure | Right ventricle | Left ventricle |
End-diastolic volume | 144 mL (± 23 mL)[7] | 142 mL (± 21 mL)[8] |
End-diastolic volume / body surface area (mL/m2) | 78 mL/m2 (± 11 mL/m2)[7] | 78 mL/m2 (± 8.8 mL/m2)[8] |
End-systolic volume | 50 mL (± 14 mL)[7] | 47 mL (± 10 mL)[8] |
End-systolic volume / body surface area (mL/m2) | 27 mL/m2 (± 7 mL/m2)[7] | 26 mL/m2 (± 5.1 mL/m2)[8] |
Stroke volume | 94 mL (± 15 mL)[7] | 95 mL (± 14 mL)[8] |
Stroke volume / body surface area (mL/m2) | 51 mL/m2 (± 7 mL/m2)[7] | 52 mL/m2 (± 6.2 mL/m2)[8] |
Ejection fraction | 66% (± 6%)[7] | 67% (± 4.6%)[8] |
Heart rate | 60–100 bpm[9]
|
60–100 bpm[9]
|
Cardiac output | 4.0–8.0 L/minute[10]
|
4.0–8.0 L/minute[10]
|
Pressures
Site | Normal pressure range (in mmHg)[11]
| |
---|---|---|
Central venous pressure | 3–8 | |
Right ventricular pressure |
systolic | 15–30 |
diastolic | 3–8 | |
Pulmonary artery pressure | systolic | 15–30 |
diastolic | 4–12 | |
Pulmonary vein/ |
2–15 | |
Left ventricular pressure |
systolic | 100–140 |
diastolic | 3–12 |
Ventricular pressure is a measure of blood pressure within the ventricles of the heart.[12]
Left
During most of the
Elevated left ventricular end-diastolic pressure has been described as a risk factor in cardiac surgery.[13]
Noninvasive approximations have been described.[14]
An elevated pressure difference between the aortic pressure and the left ventricular pressure may be indicative of aortic stenosis.[15]
Right
Right ventricular pressure demonstrates a different pressure-volume loop than left ventricular pressure.[16]
Dimensions
The heart and its performance are also commonly measured in terms of dimensions, which in this case means
Dimension | Abbreviation | Definition | Normally |
---|---|---|---|
End-diastolic dimension | EDD | The diameter across a ventricle at the end of diastole, if not else specified then usually referring to the transverse[19] (left-to-right) internal (luminal) distance, excluding thickness of walls, although it can also be measured as the external distance. | |
|
LVEDD or sometimes LVDD | The end-diastolic dimension of the left ventricle. | 48 mm,[20] Range 36 – 56 mm[21] |
|
RVEDD or sometimes RVDD | The end-diastolic dimension of the right ventricle. | Range 10 – 26 mm[21] |
End-systolic dimension | ESD | ESD is similar to the end-diastolic dimension, but is measured at the end of systole (after the ventricles have pumped out blood) rather than at the end of diastole . |
|
|
LVESD or sometimes LVSD | The end-systolic dimension of the left ventricle. | Range 20 – 40 mm[21] |
|
RVESD or sometimes RVSD | The end-systolic dimension of the right ventricle. | Range 10 – 26 mm[21] |
Interventricular septal end diastolic dimension | IVSd | The thickness of the interventricular septum. | 8.3 mm,[20] Range 7 – 11 mm[21] |
Left ventricular end diastolic posterior wall dimension | LVPWd | The thickness of the posterior left ventricular wall. | 8.3 mm,[20] Range 7 – 11 mm[21] |
Mean left ventricular myocardial thickness | Mean LVMT | Average thickness of the left ventricle, with numbers given as 95% prediction interval for the short axis images at the mid-cavity level[22] | Women: 4 - 8 mm[22] Men: 5 - 9 mm[22] |
Mean right ventricular myocardial thickness | Mean RVMT | Average thickness of the right ventricle, with numbers given as 95% prediction interval.[23] | 4 - 7 mm[23] |
Left ventricular end systolic dimension | As above but measured during systole. This measurement is not commonly used clinically. | 16 mm[24] | |
Left atrial dimension | LA | Range 24 – 40 mm[21] |
Fractional shortening (FS) is the
Clinical significance
An
Another form of arrhythmia is that of the ventricular escape beat. This can happen as a compensatory mechanism when there is a problem in the conduction system from the SA node.[citation needed]
The most severe form of arrhythmia is
See also
References
- ^ "How your Heart works?". HealthyWa.
- PMID 15728595.
- ^ Leng J. Right ventricle. In: Weyman AE, ed. Principle andpractice of echocardiography. Philadelphia: Lippincott Williams& Wilkins, 1994:901–21
- ^ a b Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: I. Anatomy, physiology, and assessment. Anesth Analg. 2009;108(2):407-21. doi:10.1213/ane.0b013e31818f8623.
- ^ a b Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: I. Anatomy, physiology, and assessment. Anesth Analg. 2009;108(2):407-21. doi:10.1213/ane.0b013e31818f8623.
- ^ Farb A, Burke AP, Virmani R. Anatomy and pathology of theright ventricle (including acquired tricuspid and pulmonicvalve disease). Cardiol Clin 1992;10:1–21
- ^ PMID 17088316.
- ^ . (subscription required)
- ^ a b Normal ranges for heart rate are among the narrowest limits between bradycardia and tachycardia. See the Bradycardia and Tachycardia articles for more detailed limits.
- ^ a b "Normal Hemodynamic Parameters – Adult" (PDF). Edwards Lifesciences LLC. 2009.
- ISBN 978-0-7817-7447-5.
- ^ Ventricular+pressure at the U.S. National Library of Medicine Medical Subject Headings (MeSH)
- PMID 16835254.
- PMID 7426202.
- ^ "Aortic Stenosis: Overview – eMedicine Emergency Medicine". Retrieved 2009-02-28.
- PMID 3342146.
- PMID 7274225.
- S2CID 22506795.
- PMID 9665096.
- ^ PMID 17957014.
- ^ ISBN 978-0-7295-3911-1.
- ^ PMID 22705587.
- ^ PMID 26702679.
- PMID 3994186.
- ^ chfpatients.com > Fractional Shortening (FS) Retrieved on April 7, 2010
- ^ "Left ventricle size – Echocardiography in ICU". Stanford.edu. 2009-06-23. Retrieved 2018-09-21.
- PMID 8176105.
- ^ a b
Ugander M, Carlsson M, Arheden H (February 2010). "Short-axis epicardial volume change is a measure of cardiac left ventricular short-axis function, which is independent of myocardial wall thickness". American Journal of Physiology. Heart and Circulatory Physiology. 298 (2): H530-5. PMID 19933422.
External links
- Photo of dissection at uc.edu
- Left Ventricle – Cell Centered Database
- Anatomy photo:20:05-0102 at the SUNY Downstate Medical Center