Right Ventricle in Arterial Hypertension: Did We Forget Something?
Right ventricular remodeling has been neglected in patients with arterial hypertension as all studies have concentrated on the left ventricle and left atrial-ventricular and ventricular-arterial coupling. The development of novel imaging techniques has revealed significant impairment in the RV struc...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/21/6257 |
| _version_ | 1797467792005398528 |
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| author | Marijana Tadic Cesare Cuspidi |
| author_facet | Marijana Tadic Cesare Cuspidi |
| author_sort | Marijana Tadic |
| collection | DOAJ |
| description | Right ventricular remodeling has been neglected in patients with arterial hypertension as all studies have concentrated on the left ventricle and left atrial-ventricular and ventricular-arterial coupling. The development of novel imaging techniques has revealed significant impairment in the RV structure, systolic and diastolic function, and, afterwards, RV longitudinal mechanics. However, these changes are subclinical and can be detected only after comprehensive imaging analysis. The latest findings confirm the importance of RV hypertrophy, systolic, and diastolic dysfunction in the prediction of cardiovascular adverse events in the hypertensive population, representing an important clinical implication of these parameters. In clinical practice, 2D echocardiography is widely used for the evaluation of RV remodeling. However, existing techniques are largely underused and limited to a few basic parameters (RV thickness and TAPSE), which are not nearly enough for a detailed assessment of RV remodeling. In addition, 3D echocardiography provides the possibility of accurate evaluation of RV volumes and ejection fraction, which are comparable with results obtained by cardiac magnetic resonance (CMR)—a gold standard for the evaluation of the RV. The use of 3D echocardiography is limited due to its low availability, the lack of adequate software necessary for the calculation of results, and the necessity for a higher level of expertise. CMR provides all information required for a detailed assessment of RV structural, functional, and mechanical remodeling, and it is considered the reference method for this type of evaluation. Furthermore, it is the only technique that may provide tissue characterization and evaluation of the interstitial space, which is essential for hypertensive heart disease. The aim of this review is to provide the current level of evidence regarding RV remodeling in patients with arterial hypertension evaluated with different imaging techniques and various parameters from each method. |
| first_indexed | 2024-03-09T18:58:45Z |
| format | Article |
| id | doaj.art-8a389ed81222410684f5d7f2b9b24dca |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T18:58:45Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8a389ed81222410684f5d7f2b9b24dca2023-11-24T05:14:47ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011121625710.3390/jcm11216257Right Ventricle in Arterial Hypertension: Did We Forget Something?Marijana Tadic0Cesare Cuspidi1Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, GermanyDepartment of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, ItalyRight ventricular remodeling has been neglected in patients with arterial hypertension as all studies have concentrated on the left ventricle and left atrial-ventricular and ventricular-arterial coupling. The development of novel imaging techniques has revealed significant impairment in the RV structure, systolic and diastolic function, and, afterwards, RV longitudinal mechanics. However, these changes are subclinical and can be detected only after comprehensive imaging analysis. The latest findings confirm the importance of RV hypertrophy, systolic, and diastolic dysfunction in the prediction of cardiovascular adverse events in the hypertensive population, representing an important clinical implication of these parameters. In clinical practice, 2D echocardiography is widely used for the evaluation of RV remodeling. However, existing techniques are largely underused and limited to a few basic parameters (RV thickness and TAPSE), which are not nearly enough for a detailed assessment of RV remodeling. In addition, 3D echocardiography provides the possibility of accurate evaluation of RV volumes and ejection fraction, which are comparable with results obtained by cardiac magnetic resonance (CMR)—a gold standard for the evaluation of the RV. The use of 3D echocardiography is limited due to its low availability, the lack of adequate software necessary for the calculation of results, and the necessity for a higher level of expertise. CMR provides all information required for a detailed assessment of RV structural, functional, and mechanical remodeling, and it is considered the reference method for this type of evaluation. Furthermore, it is the only technique that may provide tissue characterization and evaluation of the interstitial space, which is essential for hypertensive heart disease. The aim of this review is to provide the current level of evidence regarding RV remodeling in patients with arterial hypertension evaluated with different imaging techniques and various parameters from each method.https://www.mdpi.com/2077-0383/11/21/6257right ventriclearterial hypertensionspeckle trackingcardiac magnetic resonance |
| spellingShingle | Marijana Tadic Cesare Cuspidi Right Ventricle in Arterial Hypertension: Did We Forget Something? Journal of Clinical Medicine right ventricle arterial hypertension speckle tracking cardiac magnetic resonance |
| title | Right Ventricle in Arterial Hypertension: Did We Forget Something? |
| title_full | Right Ventricle in Arterial Hypertension: Did We Forget Something? |
| title_fullStr | Right Ventricle in Arterial Hypertension: Did We Forget Something? |
| title_full_unstemmed | Right Ventricle in Arterial Hypertension: Did We Forget Something? |
| title_short | Right Ventricle in Arterial Hypertension: Did We Forget Something? |
| title_sort | right ventricle in arterial hypertension did we forget something |
| topic | right ventricle arterial hypertension speckle tracking cardiac magnetic resonance |
| url | https://www.mdpi.com/2077-0383/11/21/6257 |
| work_keys_str_mv | AT marijanatadic rightventricleinarterialhypertensiondidweforgetsomething AT cesarecuspidi rightventricleinarterialhypertensiondidweforgetsomething |