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Related Concept Videos

Mitral Regurgitation I: Introduction01:20

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Cardiomyopathy I: Introduction and Classification01:25

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Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Related Experiment Video

Updated: May 5, 2026

Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension
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Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension

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Right Ventricular Restrictive Physiology Is Associated With Right Ventricular Direct Flow From 4D Flow CMR.

Xiaodan Zhao1, Phong Teck Lee1, Liwei Hu2

  • 1National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore.

JACC. Asia
|January 13, 2025
PubMed
Summary

Right ventricular restrictive physiology (RVRP) in repaired tetralogy of Fallot (rTOF) is linked to altered biventricular blood flow and kinetic energy. Increased direct flow is a key predictor of RVRP in these patients.

Keywords:
4D flow CMRflow componentkinetic energyrepaired tetralogy of Fallotright ventricular restrictive physiology

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Invasive Hemodynamic Assessment for the Right Ventricular System and Hypoxia-Induced Pulmonary Arterial Hypertension in Mice
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Area of Science:

  • Cardiovascular Imaging
  • Congenital Heart Disease
  • Hemodynamics

Background:

  • Right ventricular restrictive physiology (RVRP) is common in repaired tetralogy of Fallot (rTOF).
  • The relationship between RVRP and biventricular blood flow dynamics, including kinetic energy (KE), using 4-dimensional (4D) flow cardiovascular magnetic resonance (CMR) is not well understood.

Purpose of the Study:

  • To investigate the association between 4D flow CMR-derived parameters and RVRP in patients with rTOF.

Main Methods:

  • 103 rTOF patients and 62 controls underwent CMR (cine, 2D PC, 4D flow) and exercise testing.
  • RVRP was identified using pulmonary artery flow curves.
  • Biventricular flow components and KE (normalized to end-diastolic volume, KEiEDV) were analyzed.

Main Results:

  • rTOF patients exhibited lower RV direct flow and higher RV residual volume compared to controls.
  • RVRP was present in 68% of rTOF patients, associated with increased RV direct flow and peak E-wave KEiEDV, and decreased RV residual volume.
  • RV direct flow emerged as an independent predictor of RVRP (OR: 1.158, P < 0.001).

Conclusions:

  • RVRP in rTOF is associated with dilated RV, increased pulmonary regurgitation, and elevated RV direct flow.
  • 4D flow CMR parameters, particularly RV direct flow, can help identify RVRP in rTOF patients.