Methods for Evaluating Right Ventricular Function and Ventricular-Arterial Coupling.

Area of Science:

• Cardiology
• Pulmonary Hypertension Research
• Cardiac Physiology

Background:

• Right ventricular function (RVF) is a critical prognostic indicator in heart failure and pulmonary hypertension (PH).
• While often studied in pulmonary arterial hypertension, RVF is also vital in group 2 PH.
• Understanding RVF and the Right Ventricle-Pulmonary Artery (RV-PA) coupling is essential for patient management.

Purpose of the Study:

• To discuss the assessment of RVF.
• To evaluate the RV-PA coupling relationship.
• To provide a comprehensive overview of diagnostic modalities for RVF and RV-PA coupling.

Main Methods:

• Utilizing cardiac imaging modalities like echo-Doppler (RV fractional area change, tricuspid annular plane systolic excursion, Tissue Doppler Imaging) and cardiac magnetic resonance.
• Employing invasive hemodynamic assessment, including during exercise, to evaluate functional reserve.
• Integrating cardiopulmonary exercise testing for insights into cardiopulmonary disease mechanisms.

Main Results:

• Cardiac imaging, invasive hemodynamics, and stress testing offer sophisticated insights into RVF.
• The RV-PA coupling can be assessed using various practical, clinically available metrics.
• Combined approaches yield a more nuanced understanding of the patient's physiologic state.

Conclusions:

• Comprehensive assessment of RVF and RV-PA coupling is achievable through a combination of imaging, invasive hemodynamics, and exercise testing.
• Clinically relevant metrics allow for effective evaluation of the RV-PA coupling relationship.
• Understanding RVF and RV-PA coupling is key to improving patient outcomes in heart failure and PH.