Ahmad Ashfaq, Zou Yifan, Zhang Peng, Li Lingling, Wang Xiaoyu, Wang Yousen, Fan Fenling
Department of Cardiovascular Medicine, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
School of Economics and Finance, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Cardiovasc Med. 2024 May 9;11:1393580. doi: 10.3389/fcvm.2024.1393580. eCollection 2024.
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.
肺动脉高压（PAH）是一种慢性进行性疾病，如果不进行治疗，最终会导致心力衰竭（HF）并随后死亡。右心室（RV）功能在包括PAH在内的多种心脏病患者中已被证明具有预后价值。PAH主要是一种右心疾病；然而，鉴于连续循环系统的性质以及共用隔膜和心包限制的存在，左右心室的相互依存是一个需要考虑的因素。准确及时地评估心室功能对于PAH患者的疾病转归和预后管理非常重要。心脏磁共振成像（CMR）、超声心动图（二维和三维）以及核医学、正电子发射断层扫描（PET）等非侵入性检查方法在评估心室功能和疾病预后方面发挥着关键作用。每种检查方法都有其自身的优点和局限性，因此这篇综述文章阐明了：（i）PAH患者的心室功能障碍以及此类患者中右心室与左心室的相互依存关系；（ii）所有可用检查方法和参数在早期评估心室功能方面的优点和局限性及其预后价值；（iii）最后，这些检查方法在准确早期诊断PAH心室功能方面面临的挑战以及潜在的未来进展。
