Key result
Noninvasive imaging modalities, including echocardiography, MRI, and CT, provide deep insight into right ventricle-pulmonary artery coupling, allowing for prognostication and potential intervention.
Why the study?
Noninvasive imaging provides insight into RV-PA coupling for prognostication and potential intervention before maladaptive uncoupling occurs in cardiovascular disease.
This review highlights the utility of noninvasive imaging modalities in assessing right ventricle-pulmonary artery coupling to guide prognostication and early intervention in pulmonary vascular disease.
May aid prognostication in pulmonary vascular disease; leaves open prospective validation before guiding interventions.
The right ventricle (RV) and pulmonary arterial (PA) tree are inextricably linked, continually transferring energy back and forth in a process known as RV-PA coupling. Healthy organisms maintain this relationship in optimal balance by modulating RV contractility, pulmonary vascular resistance, and compliance to sustain RV-PA coupling through life's many physiologic challenges. Early in states of adaptation to cardiovascular disease-for example, in diastolic heart failure-RV-PA coupling is maintained via a multitude of cellular and mechanical transformations. However, with disease progression, these compensatory mechanisms fail and become maladaptive, leading to the often-fatal state of "uncoupling." Noninvasive imaging modalities, including echocardiography, magnetic resonance imaging, and computed tomography, allow us deeper insight into the state of coupling for an individual patient, providing for prognostication and potential intervention before uncoupling occurs. In this review, we discuss the physiologic foundations of RV-PA coupling, elaborate on the imaging techniques to qualify and quantify it, and correlate these fundamental principles with clinical scenarios in health and disease.
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Tsarova et al. (2022) conducted a review in Pulmonary Vascular Disease. Noninvasive imaging modalities (echocardiography, MRI, CT) was evaluated. Noninvasive imaging modalities, including echocardiography, MRI, and CT, provide deep insight into right ventricle-pulmonary artery coupling, allowing for prognostication and potential intervention.
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