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Review
Advanced imaging of right ventricular anatomy and function
  1. Luigi P Badano1,2,
  2. Karima Addetia3,
  3. Gianluca Pontone4,
  4. Camilla Torlasco1,
  5. Roberto M Lang3,
  6. Gianfranco Parati1,2,
  7. Denisa Muraru1,2
  1. 1 Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milano, Italy
  2. 2 Department of Medicine and Surgery, University of Milano–Bicocca, Milano, Italy
  3. 3 Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois, USA
  4. 4 Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milano, Italy
  1. Correspondence to Professor Luigi P Badano, Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, Istituto Scientifico San Luca, Milano 20149, Italy; luigi.badano{at}unimib.it

Abstract

Right ventricular (RV) size and function are important predictors of cardiovascular morbidity and mortality in patients with various conditions. However, non-invasive assessment of the RV is a challenging task due to its complex anatomy and location in the chest. Although conventional echocardiography is widely used, its limitations in RV assessment are well recognised. New techniques such as three-dimensional and speckle tracking echocardiography have overcome the limitations of conventional echocardiography allowing a comprehensive, quantitative assessment of RV geometry and function without geometric assumptions. Cardiac magnetic resonance (CMR) and CT provide accurate assessment of RV geometry and function, too. In addition, tissue characterisation imaging for myocardial scar and fat using CMR and CT provides important information regarding the RV that has clinical applications for diagnosis and prognosis in a broad range of cardiac conditions. Limitations also exist for these two advanced modalities including availability and patient suitability for CMR and need for contrast and radiation exposure for CT. Hybrid imaging, which is able to integrate anatomical information (usually obtained by CT or CMR) with physiological and molecular data (usually obtained with positron emission tomography), can provide optimal in vivo evaluation of Rv functional impairment. This review summarises the clinically useful applications of advanced echocardiography techniques, CMR and CT for comprehensive assessment of RV size, function and mechanics.

  • advanced cardiac imaging
  • echocardiography

https://doi.org/10.1136/heartjnl-2019-315178

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    Footnotes

    • Twitter @lpbadano

    • Contributors GP is an internationally renown expert in CCT. He provided the paragraphs and images related to CCT. CT is an internationally renown expert in cardiac magnetic resonance. She provided the paragraphs and images related to CMR. DM, KA, and RML wrote most of the echo-related paragraphs, particularly those related to 3D and speckle tracking echocardiography. LPB and GP collected all contributions, merged them and drafted the final version of the paper. DM provided most of the echo images. All the authors have read and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; externally peer reviewed.