title: Methods for Evaluating Right Ventricular Function and Ventricular-Arterial Coupling.
abstract: Right ventricular function (RVF) carries great prognostic significance in heart failure and pulmonary hypertension (PH). Although there is considerable focus on RVF in pulmonary arterial hypertension, RVF is also of great importance in group 2 PH. This article will discuss assessment of RVF and evaluation of the Right Ventricle-Pulmonary Artery (RV-PA) coupling relationship. Cardiac imaging modalities allow direct visualization and assessment of RVF. Imaging modalities include the commonly utilized echo-Doppler imaging evaluating RV fractional area change, tricuspid annular plane systolic excursion and Tissue Doppler Imaging, in addition to the increasingly utilized cardiac magnetic resonance. Invasive hemodynamic assessment also plays an important role and can also be employed during exercise to help elucidate functional reserve. Cardiopulmonary exercise testing provides added insight into the mechanisms of cardiopulmonary disease. Cardiac imaging, invasive hemodynamics, and gas exchange stress testing can be combined to give a more sophisticated understanding of RVF. The RV-PA coupling relationship can be assessed using practical and clinically available metrics in order to gain clinically relevant understanding of the patients' physiologic state. RV-PA coupling assessments can be done using invasive, combined noninvasive-invasive, or non-invasive approaches. We also discuss our approaches in the assessment of the RV-PA coupling relationship.
authors.affiliation: Department of Medicine, Temple University Hospital, Philadelphia, PA.
authors.forename: Saad
authors.initials: S
authors.lastname: Kubba
authors.affiliation: Department of Medicine, Einstein Medical Center, Philadelphia, PA.
authors.forename: Carlos D
authors.initials: CD
authors.lastname: Davila
authors.affiliation: Department of Medicine, Temple University Hospital, Philadelphia, PA; Temple Heart and Vascular Institute, Philadelphia, PA. Electronic address: Paul.Forfia@tuhs.temple.edu.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Forfia
mesh_terms: D015150:Echocardiography, Doppler; D005080:Exercise Test; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D011651:Pulmonary Artery / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Pulmonary hypertension; Reserve; Right ventricular function; Ventricular-arterial coupling