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06-04-2024 | Heart Surgery | Congenital Heart Disease (RA Krasuski and G Fleming, Section Editors)

Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions

Authors: Crosby Culp, Jon Andrews, Katherine Wang Sun, Kendall Hunter, Anne Cherry, Mihai Podgoreanu, Alina Nicoara

Published in: Current Cardiology Reports

Abstract

Purpose of Review

This review aims to summarize the fundamentals of RV-PA coupling, its non-invasive means of measurement, and contemporary understanding of RV-PA coupling in cardiac surgery, cardiac interventions, and congenital heart disease.

Recent Findings

The need for more accessible clinical means of evaluation of RV-PA coupling has driven researchers to investigate surrogates using cardiac MRI, echocardiography, and right-sided pressure measurements in patients undergoing cardiac surgery/interventions, as well as patients with congenital heart disease. Recent research has aimed to validate these alternative means against the gold standard, as well as establish cut-off values predictive of morbidity and/or mortality. This emerging evidence lays the groundwork for identifying appropriate RV-PA coupling surrogates and integrating them into perioperative clinical practice.

Del Rio JM, Grecu L, Nicoara A. Right ventricular function in left heart disease. Semin Cardiothorac Vasc Anesth. 2019;23(1):88–107. https://doi.org/10.1177/1089253218799345.CrossRefPubMed

Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: II. Pathophysiology, clinical importance, and management. Anesth Analg. 2009;108(2):422–33. https://doi.org/10.1213/ane.0b013e31818d8b92.CrossRefPubMed

Kukulski T, She L, Racine N, et al. Implication of right ventricular dysfunction on long-term outcome in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting with or without surgical ventricular reconstruction. J Thorac Cardiovasc Surg. 2015;149(5):1312–21. https://doi.org/10.1016/j.jtcvs.2014.09.117.CrossRefPubMed

Peyrou J, Chauvel C, Pathak A, Simon M, Dehant P, Abergel E. Preoperative right ventricular dysfunction is a strong predictor of 3 years survival after cardiac surgery. Clin Res Cardiol. 2017;106(9):734–42. https://doi.org/10.1007/s00392-017-1117-y.CrossRefPubMed

Elzinga G, Westerhof N. Matching between ventricle and arterial load. An evolutionary process. Circ Res. 1991;68(6):1495–500;68(6):1495–500. https://doi.org/10.1161/01.res.68.6.1495.CrossRefPubMed

West JB. Role of the fragility of the pulmonary blood-gas barrier in the evolution of the pulmonary circulation. Am J Physiol Regul Integr Comp Physiol. 2013;304(3):R171–6. https://doi.org/10.1152/ajpregu.00444.2012.CrossRefPubMed

Zaffran S, Kelly RG, Meilhac SM, Buckingham ME, Brown NA. Right ventricular myocardium derives from the anterior heart field. Circ Res. 2004;95(3):261–8. https://doi.org/10.1161/01.Res.0000136815.73623.Be.CrossRefPubMed

Frank O. Die wirkung von digitalis (helleborein) auf das herz. 1898.

Baan J, Jong TT, Kerkhof PL, et al. Continuous stroke volume and cardiac output from intra-ventricular dimensions obtained with impedance catheter. Cardiovasc Res. 1981;15(6):328–34. https://doi.org/10.1093/cvr/15.6.328.CrossRefPubMed

10.

Baan J, van der Velde ET, de Bruin HG, et al. Continuous measurement of left ventricular volume in animals and humans by conductance catheter. Circulation. 1984;70(5):812–23. https://doi.org/10.1161/01.cir.70.5.812.CrossRefPubMed

11.

Burkhoff D, van der Velde E, Kass D, Baan J, Maughan WL, Sagawa K. Accuracy of volume measurement by conductance catheter in isolated, ejecting canine hearts. Circulation. 1985;72(2):440–7. https://doi.org/10.1161/01.cir.72.2.440.CrossRefPubMed

12.

Piene H. Interaction between the right heart ventricle and its arterial load: a quantitative solution. Am J Physiol. 1980;238(6):H932–7. https://doi.org/10.1152/ajpheart.1980.238.6.H932.CrossRefPubMed

13.

Piene H, Sund T. Flow and power output of right ventricle facing load with variable input impedance. Am J Physiol. 1979;237(2):H125–30. https://doi.org/10.1152/ajpheart.1979.237.2.H125.CrossRefPubMed

14.

Abel FL, Waldhausen JA. Effects of alterations in pulmonary vascular resistance on right ventricular function. J Thorac Cardiovasc Surg. 1967;54(6):886–94.CrossRefPubMed

15.

Zile MR, Baicu CF, Gaasch WH. Diastolic heart failure—abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med. 2004;350(19):1953–9. https://doi.org/10.1056/NEJMoa032566.CrossRefPubMed

16.

Sunagawa K, Maughan WL, Burkhoff D, Sagawa K. Left ventricular interaction with arterial load studied in isolated canine ventricle. Am J Physiol. 1983;245(5 Pt 1):H773–80. https://doi.org/10.1152/ajpheart.1983.245.5.H773.CrossRefPubMed

17.

Sunagawa K, Maughan WL, Sagawa K. Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle. Circ Res. 1985;56(4):586–95. https://doi.org/10.1161/01.res.56.4.586.CrossRefPubMed

18.

Kelly RP, Ting CT, Yang TM, et al. Effective arterial elastance as index of arterial vascular load in humans. Circulation. 1992;86(2):513–21. https://doi.org/10.1161/01.cir.86.2.513.CrossRefPubMed

19.

Sagawa K. Cardiac contraction and the pressure-volume relationship. Oxford University Press; 1988.

20.

Burkhoff D, Sagawa K. Ventricular efficiency predicted by an analytical model. Am J Physiol. 1986;250(6 Pt 2):R1021–7. https://doi.org/10.1152/ajpregu.1986.250.6.R1021.CrossRefPubMed

21.

• Brener MI, Masoumi A, Ng VG, et al. Invasive right ventricular pressure-volume analysis: basic principles, clinical applications, and practical recommendations. Circ Heart Fail. 2022;15(1):e009101;15(1):e009101. https://doi.org/10.1161/circheartfailure.121.009101. This article serves as an excellent review of conductance catheter structure and function. There is also a review of pressure-volume loop measurement, analysis, and limitations.CrossRefPubMed

22.

Sunagawa K, Yamada A, Senda Y, et al. Estimation of the hydromotive source pressure from ejecting beats of the left ventricle. IEEE Trans Biomed Eng. 1980;27(6):299–305. https://doi.org/10.1109/tbme.1980.326737.CrossRefPubMed

23.

Richter MJ, Peters D, Ghofrani HA, et al. Evaluation and prognostic relevance of right ventricular-arterial coupling in pulmonary hypertension. Am J Respir Crit Care Med. 2020;201(1):116–9. https://doi.org/10.1164/rccm.201906-1195LE.CrossRefPubMed

24.

Brimioulle S, Wauthy P, Ewalenko P, et al. Single-beat estimation of right ventricular end-systolic pressure-volume relationship. Am J Physiol Heart Circ Physiol. 2003;284(5):H1625–30. https://doi.org/10.1152/ajpheart.01023.2002.CrossRefPubMed

25.

Senzaki H, Chen CH, Kass DA. Single-beat estimation of end-systolic pressure-volume relation in humans. A new method with the potential for noninvasive application. Circulation. 1996;94(10):2497–506. https://doi.org/10.1161/01.cir.94.10.2497.CrossRefPubMed

26.

Singh A, Huang X, Dai L, et al. Right ventricular function is reduced during cardiac surgery independent of procedural characteristics, reoperative status, or pericardiotomy. J Thorac Cardiovasc Surg. 2020;159(4):1430-1438.e4. https://doi.org/10.1016/j.jtcvs.2019.04.035.CrossRefPubMed

27.

Lahm T, Douglas IS, Archer SL, et al. Assessment of right ventricular function in the research setting: knowledge gaps and pathways forward. An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med. 2018;198(4):e15–43. https://doi.org/10.1164/rccm.201806-1160ST.CrossRefPubMedPubMedCentral

28.

Varma PK, Jose RL, Krishna N, Srimurugan B, Valooran GJ, Jayant A. Perioperative right ventricular function and dysfunction in adult cardiac surgery-focused review (part 1—anatomy, pathophysiology, and diagnosis). Indian J Thorac Cardiovasc Surg. 2022;38(1):45–57. https://doi.org/10.1007/s12055-021-01240-y.CrossRefPubMed

29.

Gaynor SL, Maniar HS, Bloch JB, Steendijk P, Moon MR. Right atrial and ventricular adaptation to chronic right ventricular pressure overload. Circulation. 2005;112(9 Suppl):I212–8. https://doi.org/10.1161/circulationaha.104.517789.CrossRefPubMed

30.

Friedberg MK, Redington AN. Right versus left ventricular failure: differences, similarities, and interactions. Circulation. 2014;129(9):1033–44. https://doi.org/10.1161/circulationaha.113.001375.CrossRefPubMed

31.

Amsallem M, Mercier O, Kobayashi Y, Moneghetti K, Haddad F. Forgotten no more: a focused update on the right ventricle in cardiovascular disease. JACC Heart Fail. 2018;6(11):891–903. https://doi.org/10.1016/j.jchf.2018.05.022.CrossRefPubMed

32.

Spruijt OA, de Man FS, Groepenhoff H, et al. The effects of exercise on right ventricular contractility and right ventricular-arterial coupling in pulmonary hypertension. Am J Respir Crit Care Med. 2015;191(9):1050–7. https://doi.org/10.1164/rccm.201412-2271OC.CrossRefPubMed

33.

Bogaard HJ, Abe K, Vonk Noordegraaf A, Voelkel NF. The right ventricle under pressure: cellular and molecular mechanisms of right-heart failure in pulmonary hypertension. Chest. 2009;135(3):794–804. https://doi.org/10.1378/chest.08-0492.CrossRefPubMed

34.

Houston BA, Brittain EL, Tedford RJ. Right ventricular failure. N Engl J Med. 2023;388(12):1111–25. https://doi.org/10.1056/NEJMra2207410.CrossRefPubMed

35.

Vonk Noordegraaf A, Chin KM, Haddad F, et al. Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: an update. Eur Respir J. 2019;53(1). https://doi.org/10.1183/13993003.01900-2018.

36.

Axell RG, Messer SJ, White PA, et al. Ventriculo-arterial coupling detects occult RV dysfunction in chronic thromboembolic pulmonary vascular disease. Physiol Rep. Apr 2017;5(7): https://doi.org/10.14814/phy2.13227

37.

Fourie PR, Coetzee AR, Bolliger CT. Pulmonary artery compliance: its role in right ventricular-arterial coupling. Cardiovasc Res. 1992;26(9):839–44. https://doi.org/10.1093/cvr/26.9.839.CrossRefPubMed

38.

Hsu S, Simpson CE, Houston BA, et al. Multi-beat right ventricular-arterial coupling predicts clinical worsening in pulmonary arterial hypertension. J Am Heart Assoc. 2020;9(10):e016031. https://doi.org/10.1161/jaha.119.016031.CrossRefPubMedPubMedCentral

39.

Ghuysen A, Lambermont B, Kolh P, et al. Alteration of right ventricular-pulmonary vascular coupling in a porcine model of progressive pressure overloading. Shock. 2008;29(2):197–204. https://doi.org/10.1097/SHK.0b013e318070c790.CrossRefPubMed

40.

Tello K, Dalmer A, Axmann J, et al. Reserve of right ventricular-arterial coupling in the setting of chronic overload. Circ Heart Fail. 2019;12(1): e005512. https://doi.org/10.1161/circheartfailure.118.005512.CrossRefPubMed

41.

McCabe C, White PA, Hoole SP, et al. Right ventricular dysfunction in chronic thromboembolic obstruction of the pulmonary artery: a pressure-volume study using the conductance catheter. J Appl Physiol (1985). 2014;116(4):355–63. https://doi.org/10.1152/japplphysiol.01123.2013.CrossRefPubMed

42.

Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39-e14. https://doi.org/10.1016/j.echo.2014.10.003.CrossRef

43.

Vonk Noordegraaf A, Westerhof BE, Westerhof N. The relationship between the right ventricle and its load in pulmonary hypertension. J Am Coll Cardiol. 2017;69(2):236–43. https://doi.org/10.1016/j.jacc.2016.10.047.CrossRefPubMed

44.

Trip P, Kind T, van de Veerdonk MC, et al. Accurate assessment of load-independent right ventricular systolic function in patients with pulmonary hypertension. J Heart Lung Transplant. 2013;32(1):50–5. https://doi.org/10.1016/j.healun.2012.09.022.CrossRefPubMed

45.

Tello K, Richter MJ, Axmann J, et al. More on single-beat estimation of right ventriculoarterial coupling in pulmonary arterial hypertension. Am J Respir Crit Care Med. 2018;198(6):816–8. https://doi.org/10.1164/rccm.201802-0283LE.CrossRefPubMed

46.

Heerdt PM, Kheyfets V, Charania S, Elassal A, Singh I. A pressure-based single beat method for estimation of right ventricular ejection fraction: proof of concept. Eur Respir J. 2020;55(3). https://doi.org/10.1183/13993003.01635-2019

47.

Muraru D, Spadotto V, Cecchetto A, et al. New speckle-tracking algorithm for right ventricular volume analysis from three-dimensional echocardiographic data sets: validation with cardiac magnetic resonance and comparison with the previous analysis tool. Eur Heart J Cardiovasc Imaging. 2016;17(11):1279–89. https://doi.org/10.1093/ehjci/jev309.CrossRefPubMed

48.

Vanderpool RR, Pinsky MR, Naeije R, et al. RV-pulmonary arterial coupling predicts outcome in patients referred for pulmonary hypertension. Heart. 2015;101(1):37–43. https://doi.org/10.1136/heartjnl-2014-306142.CrossRefPubMed

49.

Aubert R, Venner C, Huttin O, et al. Three-dimensional echocardiography for the assessment of right ventriculo-arterial coupling. J Am Soc Echocardiogr. 2018;31(8):905–15. https://doi.org/10.1016/j.echo.2018.04.013.CrossRefPubMed

50.

Guazzi M, Bandera F, Pelissero G, et al. Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis. Am J Physiol Heart Circ Physiol. 2013;305(9):H1373–81. https://doi.org/10.1152/ajpheart.00157.2013.CrossRefPubMed

51.

Tello K, Wan J, Dalmer A, et al. Validation of the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio for the assessment of right ventricular-arterial coupling in severe pulmonary hypertension. Circ Cardiovasc Imaging. 2019;12(9): e009047. https://doi.org/10.1161/circimaging.119.009047.CrossRefPubMedPubMedCentral

52.

Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022;43(38):3618–731. https://doi.org/10.1093/eurheartj/ehac237.CrossRefPubMed

53.

Tello K, Axmann J, Ghofrani HA, et al. Relevance of the TAPSE/PASP ratio in pulmonary arterial hypertension. Int J Cardiol. 2018;266:229–35. https://doi.org/10.1016/j.ijcard.2018.01.053.CrossRefPubMed

54.

Unlu S, Bezy S, Cvijic M, Duchenne J, Delcroix M, Voigt JU. Right ventricular strain related to pulmonary artery pressure predicts clinical outcome in patients with pulmonary arterial hypertension. Eur Heart J Cardiovasc Imaging. 2023;24(5):635–42. https://doi.org/10.1093/ehjci/jeac136.CrossRefPubMed

55.

Richter MJ, Rako ZA, Tello K. Ratio between right ventricular strain and systolic pulmonary artery pressure as a surrogate for right ventricular to pulmonary arterial coupling: validation against the gold standard. Eur Heart J Cardiovasc Imaging. 2023;24(3):e50–2. https://doi.org/10.1093/ehjci/jeac253.CrossRefPubMed

56.

Nochioka K, Querejeta Roca G, Claggett B, et al. Right ventricular function, right ventricular-pulmonary artery coupling, and heart failure risk in 4 US communities: the Atherosclerosis Risk in Communities (ARIC) study. JAMA Cardiol. 2018;3(10):939–48. https://doi.org/10.1001/jamacardio.2018.2454.CrossRefPubMedPubMedCentral

57.

Mehra MR, Naka Y, Uriel N, et al. A fully magnetically levitated circulatory pump for advanced heart failure. N Engl J Med. 2017;376(5):440–50. https://doi.org/10.1056/NEJMoa1610426.CrossRefPubMed

58.

Frankfurter C, Molinero M, Vishram-Nielsen JKK, et al. Predicting the risk of right ventricular failure in patients undergoing left ventricular assist device implantation: a systematic review. Circ Heart Fail. 2020;13(10): e006994. https://doi.org/10.1161/CIRCHEARTFAILURE.120.006994.CrossRefPubMed

59.

Nicoara A, Wright MC, Rosenkrans D, et al. Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation. J Cardiothorac Vasc Anesth. 2022;36(10):3740–6. https://doi.org/10.1053/j.jvca.2022.06.022.CrossRefPubMed

60.

Tran T, Muralidhar A, Hunter K, et al. Right ventricular function and cardiopulmonary performance among patients with heart failure supported by durable mechanical circulatory support devices. J Heart Lung Transplant. 2021;40(2):128–37. https://doi.org/10.1016/j.healun.2020.11.009.CrossRefPubMed

61.

Brener MI, Hamid NB, Fried JA, et al. Right ventricular pressure-volume analysis during left ventricular assist device speed optimization studies: insights into interventricular interactions and right ventricular failure. J Card Fail. 2021;27(9):991–1001. https://doi.org/10.1016/j.cardfail.2021.04.019.CrossRefPubMed

62.

Adamo M, Maccagni G, Fiorina C, et al. Prognostic value of right ventricle to pulmonary artery coupling in transcatheter aortic valve implantation recipients. J Cardiovasc Med (Hagerstown). 2022;23(9):615–22. https://doi.org/10.2459/JCM.0000000000001336.CrossRefPubMed

63.

Alwan L, Tomii D, Heg D, et al. Impact of right ventricular-pulmonary arterial coupling on clinical outcomes in patients undergoing transcatheter aortic valve implantation. Cardiovasc Revasc Med. 2023. https://doi.org/10.1016/j.carrev.2023.05.008

64.

• Cahill TJ, Pibarot P, Yu X, et al. Impact of right ventricle-pulmonary artery coupling on clinical outcomes in the PARTNER 3 trial. JACC Cardiovasc Interv. 2022;15(18):1823–1833;15(18):1823–33. https://doi.org/10.1016/j.jcin.2022.07.005. Investigators in this study used echocardiographic means of assessment of RV-PA coupling in patients with severe sortic stenosis randomized to surgical or transcatheter valve replacement, using TAPSE/PASP (PASP estimated using right-ventricular systolic pressure derived from a tricuspid regurgitation jet). A cut-off point of 0.55 was established, and prognostic significance was demonstarted as patients identified as having RV-PA uncoupling had a 2-fold increase in all-cause mortality, stroke, and rehospitalization at two years.CrossRefPubMed

65.

Dumitrof LC, Nedelciuc I, Roca M, Crisan-Dabija R, Mihaescu T, Tinica G. The evolution of pulmonary hypertension and its prognostic implications post-TAVI-single center experience. Medicina (Kaunas). 2022;58(9). https://doi.org/10.3390/medicina58091182

66.

Lillo R, Graziani F, Ingrasciotta G, et al. Right ventricle systolic function and right ventricle-pulmonary artery coupling in patients with severe aortic stenosis and the early impact of TAVI. Int J Cardiovasc Imaging. 2022;38(8):1761–70. https://doi.org/10.1007/s10554-022-02569-0.CrossRefPubMed

67.

Meucci MC, Malara S, Butcher SC, et al. Evolution and prognostic impact of right ventricular-pulmonary artery coupling after transcatheter aortic valve replacement. JACC Cardiovasc Interv. 2023;16(13):1612–21. https://doi.org/10.1016/j.jcin.2023.05.003.CrossRefPubMed

68.

Parasca CA, Calin A, Cadil D, et al. Right ventricle to pulmonary artery coupling after transcatheter aortic valve implantation—determinant factors and prognostic impact. Front Cardiovasc Med. 2023;10:1150039. https://doi.org/10.3389/fcvm.2023.1150039.CrossRefPubMedPubMedCentral

69.

Sultan I, Cardounel A, Abdelkarim I, et al. Right ventricle to pulmonary artery coupling in patients undergoing transcatheter aortic valve implantation. Heart. 2019;105(2):117–21. https://doi.org/10.1136/heartjnl-2018-313385.CrossRefPubMed

70.

Raina A, Vaidya A, Gertz ZM, Susan C, Forfia PR. Marked changes in right ventricular contractile pattern after cardiothoracic surgery: implications for post-surgical assessment of right ventricular function. J Heart Lung Transplant. 2013;32(8):777–83. https://doi.org/10.1016/j.healun.2013.05.004.CrossRefPubMed

71.

Brener MI, Lurz P, Hausleiter J, et al. Right ventricular-pulmonary arterial coupling and afterload reserve in patients undergoing transcatheter tricuspid valve repair. J Am Coll Cardiol. 2022;79(5):448–61. https://doi.org/10.1016/j.jacc.2021.11.031.CrossRefPubMed

72.

Karam N, Stolz L, Orban M, et al. Impact of right ventricular dysfunction on outcomes after transcatheter edge-to-edge repair for secondary mitral regurgitation. JACC Cardiovasc Imaging. 2021;14(4):768–78. https://doi.org/10.1016/j.jcmg.2020.12.015.CrossRefPubMed

73.

Popolo Rubbio A, Testa L, Granata G, et al. Prognostic significance of right ventricle to pulmonary artery coupling in patients with mitral regurgitation treated with the MitraClip system. Catheter Cardiovasc Interv. 2022;99(4):1277–86. https://doi.org/10.1002/ccd.30044.CrossRefPubMed

74.

Sert S, Selcuk N, Yildirimturk O, Orhan G. Prognostic value of TAPSE/PASP ratio in right ventricular failure after left ventricular assist device implantation: experience from a tertiary center. Turk Gogus Kalp Damar Cerrahisi Derg. 2022;30(3):334–43. https://doi.org/10.5606/tgkdc.dergisi.2022.23218.CrossRefPubMedPubMedCentral

75.

Soesanto AM, Hendiperdana MR, Zahara R, et al. Association between right ventricle-pulmonary artery coupling with in-hospital outcome after triple valve surgery in rheumatic heart disease. J Cardiovasc Echogr Oct-Dec. 2022;32(4):212–7. https://doi.org/10.4103/jcecho.jcecho_57_22.CrossRef

76.

Hiremath GB, Callahan S, Thatte R, Rockefeller N, Nawaytou T, Redd H, Hussain SV, Brener T. MI. Clinical applications of pressure-volume assessment in congenital heart disease. J Soc Cardiovasc Angiogr Interv. 2023;2(3).

77.

Latus H, Binder W, Kerst G, Hofbeck M, Sieverding L, Apitz C. Right ventricular-pulmonary arterial coupling in patients after repair of tetralogy of Fallot. J Thorac Cardiovasc Surg. 2013;146(6):1366–72. https://doi.org/10.1016/j.jtcvs.2013.02.039.CrossRefPubMed

78.

Sandeep B, Huang X, Li Y, et al. Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement. J Cardiothorac Surg. 2020;15(1):241. https://doi.org/10.1186/s13019-020-01281-1.CrossRefPubMedPubMedCentral

79.

Li W, West C, McGhie J, et al. Consensus recommendations for echocardiography in adults with congenital heart defects from the International Society of Adult Congenital Heart Disease (ISACHD). Int J Cardiol. 2018;272:77–83. https://doi.org/10.1016/j.ijcard.2018.07.058.CrossRefPubMed

80.

Egbe AC, Kothapalli S, Miranda WR, et al. Assessment of right ventricular-pulmonary arterial coupling in chronic pulmonary regurgitation. Can J Cardiol. 2019;35(7):914–22. https://doi.org/10.1016/j.cjca.2019.03.009.CrossRefPubMed

81.

Panaioli E, Birritella L, Graziani F, et al. Right ventricle-pulmonary artery coupling in repaired tetralogy of Fallot with pulmonary regurgitation: clinical implications. Arch Cardiovasc Dis. 2022;115(2):67–77. https://doi.org/10.1016/j.acvd.2021.12.006.CrossRefPubMed

82.

Egbe AC, Miranda WR, Said SM, et al. Risk stratification and clinical outcomes after surgical pulmonary valve replacement. Am Heart J. 2018;206:105–12. https://doi.org/10.1016/j.ahj.2018.09.012.CrossRefPubMed

83.

Vitarelli A, Miraldi F, Capotosto L, et al. Comprehensive echocardiographic assessment of right ventricular function, pulmonary arterial elastic properties and ventricular-vascular coupling in adult patients with repaired tetralogy of fallot: clinical significance of 3D derived indices. Int J Cardiovasc Imaging. 2023;39(9):1631–41. https://doi.org/10.1007/s10554-023-02857-3.CrossRefPubMed

84.

Li M, Wang Y, Li H, et al. A prediction model of simple echocardiographic variables to screen for potentially correctable shunts in adult patients with pulmonary arterial hypertension associated with atrial septal defects: a cross-sectional study. Int J Cardiovasc Imaging. 2021;37(5):1551–62. https://doi.org/10.1007/s10554-020-02128-5.CrossRefPubMed

85.

Suzuki M, Matsumoto K, Tanaka Y, et al. Preoperative coupling between right ventricle and pulmonary vasculature is an important determinant of residual symptoms after the closure of atrial septal defect. Int J Cardiovasc Imaging. 2021;37(10):2931–41. https://doi.org/10.1007/s10554-021-02282-4.CrossRefPubMed

86.

Rao PS. Single ventricle—a comprehensive review. Children (Basel). 2021;8(6). https://doi.org/10.3390/children8060441

87.

Steflik D, Butts RJ, Baker GH, et al. A preliminary comparison of two-dimensional speckle tracking echocardiography and pressure-volume loop analysis in patients with Fontan physiology: the role of ventricular morphology. Echocardiography. 2017;34(9):1353–9. https://doi.org/10.1111/echo.13641.CrossRefPubMedPubMedCentral

88.

Herberg U, Gatzweiler E, Breuer T, Breuer J. Ventricular pressure-volume loops obtained by 3D real-time echocardiography and mini pressure wire—a feasibility study. Clin Res Cardiol. 2013;102(6):427–38. https://doi.org/10.1007/s00392-013-0548-3.CrossRefPubMed

89.

• Richter MJ, Yogeswaran A, Husain-Syed F, et al. A novel non-invasive and echocardiography-derived method for quantification of right ventricular pressure-volume loops. Eur Heart J Cardiovasc Imaging. 2022;23(4):498–507. https://doi.org/10.1093/ehjci/jeab038. This proof-of-concept study by Richter et al demonstrates methods to create pressure-volume loops using echocardiography alone, as well as with echocardiography and RV pressure monitoring.CrossRefPubMed

90.

Kim D, Park Y, Choi KH, et al. Prognostic implication of RV coupling to pulmonary circulation for successful weaning from extracorporeal membrane oxygenation. JACC Cardiovasc Imaging. 2021;14(8):1523–31. https://doi.org/10.1016/j.jcmg.2021.02.018.CrossRefPubMed

91.

Cheng S, Li VW, So EK, Cheung YF. Right ventricular-pulmonary arterial coupling in repaired tetralogy of Fallot. Pediatr Cardiol. 2022;43(1):207–17. https://doi.org/10.1007/s00246-021-02719-6.CrossRefPubMed

92.

Oh J, Song IK, Cho J, et al. Acute change in ventricular contractility-load coupling after corrective surgery for congenital heart defect: a retrospective cohort study. Pediatr Cardiol. 2019;40(8):1618–26. https://doi.org/10.1007/s00246-019-02195-z.CrossRefPubMedPubMedCentral

93.

Egbe AC, Miranda WR, Pellikka PA, et al. Right ventricular and pulmonary vascular function indices for risk stratification of patients with pulmonary regurgitation. Congenit Heart Dis. 2019;14(4):657–64. https://doi.org/10.1111/chd.12768.CrossRefPubMedPubMedCentral

94.

Lee SH, Shin YR, Kim DY, et al. Clinical significance of right ventricular-pulmonary arterial coupling in patients with tricuspid regurgitation before closure of atrial septal defect. Front Cardiovasc Med. 2022;9: 896711. https://doi.org/10.3389/fcvm.2022.896711.CrossRefPubMedPubMedCentral

95.

Butts RJ, Chowdhury SM, Buckley J, et al. Comparison of echocardiographic and pressure-volume loop indices of systolic function in patients with single ventricle physiology: a preliminary report. Congenit Heart Dis Jan-Feb. 2015;10(1):E17-24. https://doi.org/10.1111/chd.12191.CrossRef

96.

Schlangen J, Fischer G, Petko C, et al. Arterial elastance and its impact on intrinsic right ventricular function in palliated hypoplastic left heart syndrome. Int J Cardiol. 2013;168(6):5385–9. https://doi.org/10.1016/j.ijcard.2013.08.052.CrossRefPubMed

Title: Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions
Authors: Crosby Culp
Jon Andrews
Katherine Wang Sun
Kendall Hunter
Anne Cherry
Mihai Podgoreanu
Alina Nicoara
Publication date: 06-04-2024
Publisher: Springer US
Keywords: Heart Surgery
Heart Surgery
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Published in: Current Cardiology Reports
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-024-02052-3

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Springer Medicine

Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions

Abstract

Purpose of Review

Recent Findings

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At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

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ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page