Current State of RV Multimodality Imaging in Pediatric Pulmonary Hypertension: Current Evidence, Knowledge Gaps, and...

Area of Science:

• Pediatric Cardiology
• Cardiovascular Imaging
• Pulmonary Hypertension Research

Background:

• Right ventricular (RV) failure significantly impacts morbidity and mortality in pediatric pulmonary hypertension.
• Accurate RV assessment is vital for risk stratification and long-term management.
• Current noninvasive imaging modalities have limitations in evaluating the pediatric RV.

Purpose of the Study:

• To critically review noninvasive multimodality imaging of the RV in pediatric pulmonary hypertension.
• To identify key knowledge gaps and limitations of current imaging techniques.
• To propose a roadmap for future research and collaborative initiatives.

Main Methods:

• Comprehensive review of existing evidence on noninvasive imaging of the pediatric RV in pulmonary hypertension.
• Parallel presentation of echocardiography and cardiac magnetic resonance imaging to highlight complementary roles.
• Structured discussion around fundamental aspects of RV physiology and function.

Main Results:

• Commonly used imaging modalities (echocardiography, cardiac MRI) have distinct advantages and limitations in pediatric populations.
• An integrated, multimodal imaging strategy is required for comprehensive RV evaluation.
• Current prognostic thresholds are largely based on low-level evidence (Level C), indicating significant knowledge gaps.

Conclusions:

• A multimodal imaging approach is essential for accurate RV assessment in pediatric pulmonary hypertension.
• Further research is needed to address current evidence gaps and develop definitive clinical recommendations.
• Collaborative efforts and professional networks are crucial for advancing the field.