Abstract:
Pulmonary arterial hypertension (PAH) is a chronic and progressive disease that eventually leads to heart failure (HF) and subsequent fatality if left untreated. Right ventricular (RV) function has proven prognostic values in patients with a variety of heart diseases including PAH. PAH is predominantly a right heart disease; however, given the nature of the continuous circulatory system and the presence of shared septum and pericardial constraints, the interdependence of the right and left ventricles is a factor that requires consideration. Accurate and timely assessment of ventricular function is very important in the management of patients with PAH for disease outcomes and prognosis. Non-invasive modalities such as cardiac magnetic resonance (CMR) and echocardiography (two-dimensional and three-dimensional), and nuclear medicine, positron emission tomography (PET) play a crucial role in the assessment of ventricular function and disease prognosis. Each modality has its own strengths and limitations, hence this review article sheds light on (i) ventricular dysfunction in patients with PAH and RV-LV interdependence in such patients, (ii) the strengths and limitations of all available modalities and parameters for the early assessment of ventricular function, as well as their prognostic value, and (iii) lastly, the challenges faced and the potential future advancement in these modalities for accurate and early diagnosis of ventricular function in PAH.
摘要:
肺动脉高压(PAH)是一种慢性和进行性疾病,如果不及时治疗,最终会导致心力衰竭(HF)和随后的死亡。右心室(RV)功能已被证明对包括PAH在内的各种心脏病患者具有预后价值。PAH主要是右心疾病;然而,考虑到连续循环系统的性质以及共享的隔膜和心包约束的存在,右心室和左心室的相互依赖是一个需要考虑的因素.准确及时地评估心室功能对于PAH患者的预后和预后管理非常重要。非侵入性的方式,如心脏磁共振(CMR)和超声心动图(二维和三维),核医学,正电子发射断层扫描(PET)在评估心室功能和疾病预后中起着至关重要的作用。每种模式都有自己的优势和局限性,因此,这篇综述文章阐明了(i)PAH患者的心室功能障碍和此类患者的RV-LV相互依存,(ii)早期评估心室功能的所有可用模式和参数的优势和局限性,以及它们的预后价值,(三)最后,这些方法在准确和早期诊断PAH心室功能方面面临的挑战和未来的潜在进展。