title: State of the Art Review of the Right Ventricle in COPD Patients: It is Time to Look Closer.
abstract: Since the first description of pulmonary circulation in the 16th century, the knowledge of the complex interaction between the heart and lungs has greatly improved. Hypoxemia plays a classical role in the development of complications such as pulmonary hypertension and right ventricle (RV) dysfunction in patients presenting with chronic obstructive pulmonary disease (COPD). However, more recent results have revealed the presence of RV vascular structural and functional changes even in patients with mild COPD, without hypoxemia or pulmonary hypertension at rest. Compared to the left ventricle, the anatomy of the RV is unique and complex, which makes its assessment more difficult during routine exams. Therefore, it is common that very little attention is paid to its study. In this article, the physiological aspects of pulmonary circulation and the RV, as well as their impairment in COPD patients, are presented. In addition, important aspects of the recommendations for RV assessment using echocardiography are approached and studies that used other complementary exams to evaluate RV structure and function are revisited. Finally, the findings of studies that assessed the impact of RV dysfunction in the prognosis of patients with COPD are described.
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, Rua 235 c/1a. Avenida s/n, Setor Universitário, 74605-020, Goiânia, GO, Brazil. danielatannus@gmail.com.
authors.forename: Daniela Graner Schuwartz
authors.identifier: 0000-0003-1305-7914
authors.initials: DG
authors.lastname: Tannus-Silva
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, Rua 235 c/1a. Avenida s/n, Setor Universitário, 74605-020, Goiânia, GO, Brazil.
authors.forename: Marcelo Fouad
authors.initials: MF
authors.lastname: Rabahi
mesh_terms: D004452:Echocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011652:Pulmonary Circulation; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*
keywords: COPD; Echocardiography; Right ventricle assessment; Right ventricle dysfunction