title: Estimating Right Atrial Pressure Using Ultrasounds: An Old Issue Revisited With New Methods.
abstract: Knowledge of the right atrial pressure (RAP) values is critical to ascertain the existence of a state of hemodynamic congestion, irrespective of the possible presence of signs and symptoms of clinical congestion and cardiac overload that can be lacking in some conditions of concealed or clinically misleading cardiac decompensation. In addition, a more reliable estimate of RAP would make it possible to determine more accurately also the systolic pulmonary arterial pressure with the only echocardiographic methods. The authors briefly illustrate some of the criteria that have been implemented to obtain a non-invasive RAP estimate, some of which have been approved by current guidelines and others are still awaiting official endorsement from the Scientific Societies of Cardiology. There is a representation of the sometimes opposing views of researchers who have studied the problem, and the prospects for development of new diagnostic criteria are outlined, in particular those derived from the matched use of two- and three-dimensional echocardiographic parameters.
authors.affiliation: Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 Centro, Napoli, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: De Vecchis
authors.affiliation: Heart Department, Interventional Cardiology, A.O.U. "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Baldi
authors.affiliation: Hospital Directorate, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 Centro, Napoli, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giandomenico
authors.affiliation: Department of Cardiology, Second University of Napoli, Monaldi Hospital, Napoli, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Di Maio
authors.affiliation: Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 Centro, Napoli, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Giasi
authors.affiliation: Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 Centro, Napoli, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Cioppa
keywords: 3D echocardiography; Inferior vena cava; Right atrial pressure; Ultrasound monitoring