The septal motor of biventricular function.
This paper describes the anatomic spiral arrangement of the cardiac interventricular septum that results in a twisting action that contributes to the forceful ejection of blood from both ventricles during systole. Right ventricular (RV) dysfunction seen in various clinical settings is discussed with reference to the septum and its mechanism of function. The role of the septum in the interdependence of ventricular function is described. The structure/function relationships of the septum are related to maintenance of its oblique fiber orientation and midline configuration; disruption of this spatial relationship is the lynchpin of the concept that 'left heart failure begets right heart failure.' The importance of recognizing how alterations in septal anatomy affect biventricular performance is related to improved understanding of the clinical manifestations of septal dysfunction, designing a management scheme, and determining how to prevent septal injury.
Department of Medicine, David Geffen School of Medicine at UCLA, USA.
Saleh
S
Saleh
Oliver J
OJ
Liakopoulos
Gerald D
GD
Buckberg
D006330:Heart Defects, Congenital / Q000503:physiopathology; D006333:Heart Failure / Q000473:pathology / Q000503:physiopathology; D006346:Heart Septum / Q000033:anatomy & histology* / Q000502:physiology* / Q000503:physiopathology; D016027:Heart Transplantation; D006352:Heart Ventricles / Q000002:abnormalities; D006801:Humans; D008955:Models, Cardiovascular; D018497:Ventricular Dysfunction, Right / Q000473:pathology / Q000503:physiopathology; D016276:Ventricular Function