Right ventricular perfusion: Do we need additional evidence or just a simple methodology?

Excerpt

The importance of right ventricular involvement in cardiovascular disease states, including coronary artery disease, is unanimously accepted.1^–3 Nevertheless, the right ventricular evaluation still represents a quite negligible indication for the use of diagnostic imaging techniques. There are no doubts that this is mainly due to the predominant role of the left ventricle in the physiopathology of coronary artery disease and of heart failure syndromes. Another reason resides in the intrinsic difficulties of right ventricular imaging. This is true for the assessment of function, because of the complex geometrical shape of the right ventricle.4 The limitations of echocardiography and even of cardiac magnetic resonance when dealing with the measurement of right ventricular volumes and ejection fraction, and with the assessment of wall motion, are well known.4 As regards to this, it is worth mentioning that radionuclide techniques, and in particular first pass angiocardiography and gated blood pool single photon emission computed tomography (SPECT), although heavily underutilized, are considered among the most reliable approaches for an accurate estimate of right ventricular function.5^–7 …