With each heartbeat, the right ventricle (RV) inputs blood into the pulmonary vascular (PV) compartment which conducts blood through the lungs at low pressure and concurrently fills the left atrium (LA) for output to the systemic circulation. This overall hemodynamic function of the integrated RV-PV-LA unit is determined by complex interactions between the components that vary over the cardiac cycle but are often assessed in terms of mean pressure and flow. Exercise challenges these hemodynamic interactions as cardiac filling increases, stroke volume augments, and cycle length decreases, with PV pressures ultimately increasing in association with cardiac output. Recent cardio-pulmonary exercise hemodynamic studies have enriched the available data from healthy adults, yielded insight into the underlying mechanisms which modify the PV pressure-flow relationship, and better delineated the normal limits of healthy responses to exercise. This review will examine hemodynamic function of the RV-PV-LA unit using the 2-element Windkessel model for the pulmonary circulation. It will focus on acute PV and LA responses that accommodate increased RV output during exercise, including PV recruitment and distension and LA reservoir expansion, and the integrated mean pressure-flow response to exercise in healthy adults. Finally, it will consider how these responses may be impacted by age-related remodeling and modified by sex-related cardio-pulmonary differences. Studying the determinants and recognizing the normal limits of PV pressure-flow relations during exercise will improve our understanding of cardio-pulmonary mechanisms that facilitate or limit exercise.

中文翻译：

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右心室-肺血管-左心房单位的血流动力学功能：健康成人对运动的正常反应

随着每次心跳，右心室 (RV) 将血液输入肺血管 (PV) 隔室，该隔室在低压下通过肺部传导血液，同时充满左心房 (LA) 以输出到体循环。集成 RV-PV-LA 单元的整体血液动力学功能由组件之间复杂的相互作用决定，这些组件在心动周期内变化，但通常根据平均压力和流量进行评估。随着心脏充盈增加、每搏输出量增加和周期长度减少，运动会挑战这些血流动力学相互作用，最终 PV 压力与心输出量相关联。最近的心肺运动血流动力学研究丰富了来自健康成人的可用数据，深入了解了改变 PV 压力-流量关系的潜在机制，并更好地描绘了对运动的健康反应的正常限制。本综述将使用肺循环的 2 元素 Windkessel 模型检查 RV-PV-LA 装置的血流动力学功能。它将侧重于适应运动期间增加的 RV 输出的急性 PV 和 LA 反应，包括 PV 募集和扩张和 LA 水库扩张，以及健康成人对运动的综合平均压力-流量反应。最后，它将考虑这些反应如何受到与年龄相关的重塑和与性别相关的心肺差异的影响。