Right ventricular (RV) size and function, assessed by various imaging parameters that reflect the ability to image the initial and longitudinal RV response to stress, are integral to assessing outcomes in different cardiovascular diseases, including pulmonary hypertension left heart failure and valvular heart diseases. A JACC Scientific Statement published May 8 in JACC, reviews the standard and novel imaging methods for assessing RV function and the impact of the parameters on different disease outcomes.

In the statement, Rebecca T. Hahn, MD, FACC, et al., write that given the unique anatomy and physiology of the right heart, noninvasive assessment has significant limitations. There is a “major gap in our ability to predict outcomes using imaging” due to the “need to assess multiple morphological and physiologic changes in the RV under varying loading conditions.” As all imaging modalities have strengths and weaknesses, they note that a multimodality approach is needed and that novel parameters of RV function are being investigated.

According to the statement, echocardiography remains the most common imaging modality for RV assessment, but cardiac computed tomography (CT) and cardiac magnetic resonance (CMR) add additional parameters by providing “detailed images that allow the calculation of RV volumes throughout the cardiac cycle and the calculation of right ventricular ejection fraction (RVEF).”

The statement reviews RV morphology and physiology, measures of right heart size and function, and RV function and outcomes in specific diseases.

The authors conclude that novel imaging modalities and the use of artificial intelligence may further improve assessment of RV dysfunction.

Clinical Topics: Valvular Heart Disease

Keywords: Heart Valve Diseases, Artificial Intelligence, Cardiovascular Diseases, Stroke Volume, Ventricular Function, Right

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