Echocardiographic Grading of Right Ventricular Afterload in Left Heart Disease: Relation to Right Ventricular Function, Pulsatile and Resistant Load, and Outcome

The molecular mechanisms driving right ventricular (RV) adaptation to stress and failure in end-stage heart failure (HF) are largely unknown. We aimed to characterize myocardial transcriptional changes in the RV caused by left sided HF and comparing RV compensation to failure. 

The right ventricle (RV), because of its anatomic location and contractile pattern, has remained an elusive target for accurate characterization by echocardiography in both healthy children and various disease states. As such, cardiac magnetic resonance (CMR) imaging remains the gold standard for myocardial assessment and RV function.

Although right ventricle (RV) dysfunction drives clinical worsening in pulmonary hypertension (PH), information about RV function has not been well integrated in PH risk assessment. The gold standard for assessing RV function and ventriculo-arterial coupling is the construction of multi-beat pressure–volume (PV) loops.

Increased pulmonary artery systolic pressure (PASP) with downstream consequences on the right ventricle (RV) is the shared hallmark of the various forms of pulmonary hypertension (PH). The underlying pathophysiology of elevated PASP varies greatly between PH classification groups.