Echocardiography in Pulmonary Arterial Hypertension

In the context of pulmonary arterial hypertension (PAH), echocardiographic assessment of right ventricular (RV) function is key to determining disease severity and prognosis. Using Doppler echocardiography (ECHO) there are numerous ways that RV function can be measured, either directly or indirectly, to capture the triad of changes in RV geometry, right-to-left interaction, and RV systolic dysfunction in response to high pulmonary vascular resistance states, such as PAH. To fully evaluate and characterize the nature and extent of the impact of PAH on the RV in an individual patient, it is critical to assess a combination of these direct and indirect measures of RV function. In order to predict changes in status and have prognostic significance, the variables used must be easy to measure, reproducible, and clinically relevant. This review assesses the relative value of different ECHO parameters and looks at what the future holds for ECHO imaging of the right heart in PAH.