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      Echocardiographic evaluation of right ventricular-arterial coupling in pulmonary hypertension

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          Abstract

          Pulmonary hypertension (PH) is a hemodynamic condition characterized by chronically elevated mean pulmonary artery pressure (m-PAP ≥ 25 mmHg) measured at rest by right heart catheterization (RHC). It includes a pre-capillary and a post-capillary form. Pulmonary artery hypertension (PAH) is a pre-capillary form of PH potentially generated by several heterogeneous systemic disorders, whose main hemodynamic change is represented by severely increased pulmonary vascular resistance (PVR). In order to preserve an efficient right ventricular-arterial (RV-PA) coupling, the right ventricle (RV) adapts to this chronic increase of its afterload, with a compensatory hypertrophy, until RV dilatation and dysfunction occur. Right ventricular (RV) function and especially RV-PA coupling assessment showed to be very important prognostic markers in this subset of patients, especially for those with pre-capillary PH. The aim of this review is to provide a pathophysiological insight into the spectrum of RV adaptive changes occurring in response to chronic increase of RV afterload and to present the role of echocardiographic parameters as possible tools for early non-invasive evaluation of RV-PA coupling, before overt heart failure ensues.

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          Author and article information

          Journal
          Am J Cardiovasc Dis
          Am J Cardiovasc Dis
          ajcd
          American Journal of Cardiovascular Disease
          e-Century Publishing Corporation
          2160-200X
          2020
          15 October 2020
          : 10
          : 4
          : 272-283
          Affiliations
          [1 ] Department of Cardiology, Papardo Hospital Messina, Italy
          [2 ] Department of Clinical and Experimental Medicine - Cardiology Unit - University of Messina Messina, Italy
          [3 ] Aurora Research Institute, Aurora Health Care Milwaukee, WI, Italy
          Author notes
          Address correspondence to: Dr. Maria Chiara Todaro, Department of Cardiology, Papardo Hospital, Contrada Papardo 98158, Messina, Italy. Tel: + 39 3471776429; E-mail: kiaratodaro@ 123456yahoo.it
          [*]

          Equal contributors.

          Article
          PMC7675169 PMC7675169 7675169
          7675169
          33224574
          649412b9-7f34-417a-b953-d8685103ba38
          AJCD Copyright © 2020
          History
          : 18 June 2020
          : 24 August 2020
          Categories
          Review Article

          right ventricular-arterial coupling,echocardiography,Pulmonary hypertension

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