November 30, 2011European Respiratory Review258 citationsOpen Access
The role of the right ventricle in pulmonary arterial hypertension
Key Result
Right ventricular function is the main determinant of survival in pulmonary arterial hypertension, and noninvasive assessment using echocardiography and cardiac magnetic resonance imaging provides important prognostic information.
Structured PICO
P
Population
Patients with pulmonary arterial hypertension (PAH)
Right ventricular function is a critical determinant of survival in PAH, emphasizing the need for noninvasive monitoring and targeted therapies.
Limitations
- Echocardiography is operator-dependent and limited by acoustic window.
- CMRI is expensive, not widely available, and incompatible with ferromagnetic objects.
- There is a lack of long-term data on the prognostic value of right ventricle parameters and on the effects of PAH-specific therapies on the right ventricle.
Abstract
Although changes in the pulmonary vasculature are the primary cause of pulmonary arterial hypertension (PAH), severity of symptoms and survival are strongly associated with right ventricular function, and right heart failure is the main cause of death in patients with PAH. Echocardiography and cardiac magnetic resonance imaging allow noninvasive evaluation of right ventricular function and structure, and a number of indices have been shown to have potential prognostic value in PAH. Given the importance of the right ventricle in PAH, preservation and improvement of its function should be important aspects of therapy; however, there are currently few data specifically related to this aspect of treatment response. Simple, reproducible, noninvasive measures of right ventricular function would help to improve the management of patients with PAH, and to provide tools with which to help establish the optimal therapeutic approach to manage not only the effects of the disease on the pulmonary vasculature, but also to support and improve right ventricular function.