Pulmonary hypertension and right-heart remodeling
Pulmonary hypertension and right-heart disease often remodel the RV, RA, tricuspid annulus, and longitudinal pumping mechanics. CardiacNexus provides right-sided chamber size, function, atrial, and cross-chamber phenotypes that can support this interpretation.
- Modality
- Cine short-axis and cine long-axis CMR
- Pipeline step
- Clinical interpretation
- Outputs
- RV, RA, AVPD, atrial, and flow-context phenotypes
- Maturity
- Clinician review draft
What clinicians look for
Readers usually inspect RV EDV/ESV, RV EF, RV stroke volume, RA size, RA phasic function, AVPD, septal-lateral contribution context, and valve/flow features where relevant. Right-heart interpretation is pattern-based and depends heavily on loading conditions [1].
Relevant CardiacNexus phenotypes
| Phenotype page | Measurements to inspect | Interpretation role |
|---|---|---|
| Ventricular structure | RV EDV, RV ESV | RV dilation and remodeling |
| Ventricular function | RV EF, RV SV, RV CO | Right ventricular pump function |
| Atrial structure | RA volume and dimensions | Right atrial remodeling |
| Atrial function | RA-related context where available | Filling and reservoir context |
| Cross-chamber phenotypes | AVPD and regional contribution context | Long-axis pump contribution |
Interpretation patterns
RV enlargement with reduced RV EF and RA enlargement supports right-heart remodeling context. AVPD and regional stroke-volume contribution may provide additional insight into longitudinal function, but current outputs should be checked against implementation maturity.
Limitations
Pulmonary artery pressure, right-heart catheterization, pulmonary vascular resistance, and tricuspid regurgitation severity are not derived by CardiacNexus. RV segmentation and basal-slice handling are common QC risks.
Source audit
- Draft primer checked against promoted ventricular structure, ventricular function, atrial structure/function, and cross-chamber phenotype pages.
- Pulmonary-hypertension wording is constrained to right-heart remodeling context; CardiacNexus does not estimate invasive pressure, pulmonary vascular resistance, or PH subtype.
docs/data/reference_sources.ymlexists and is the current registry for AVPD, regional contribution, and right-heart context sources.- Textbook context boundary: broad Braunwald/Hurst pulmonary-hypertension and right-heart-remodeling background was treated only as clinical context; the promoted phenotype pages and page-specific PH/AVPD sources cover the draft needs.
- Textbook route checked: Braunwald Pulmonary Hypertension, printed pages 286-308. It is used only as broad right-heart disease context; CardiacNexus does not estimate invasive pressure or PH subtype.
References
- Goransson C, Vejlstrup N, Carlsen J. Reproducibility of Peak Filling and Peak Emptying Rate Determined by Cardiovascular Magnetic Resonance Imaging for Assessment of Biventricular Systolic and Diastolic Dysfunction in Patients with Pulmonary Arterial Hypertension. The International Journal of Cardiovascular Imaging. 2017.
- Ostenfeld E, Stephensen SS, Steding-Ehrenborg K, Heiberg E, Arheden H, Radegran G, Holm J, Carlsson M. Regional Contribution to Ventricular Stroke Volume Is Affected on the Left Side, but Not on the Right in Patients with Pulmonary Hypertension. The International Journal of Cardiovascular Imaging. 2016;32(8):1243-1253. doi:10.1007/s10554-016-0898-9.
- Hasselberg NE, Kagiyama N, Soyama Y, Sugahara M, Goda A, Ryo-Koriyama K, Batel O, Chakinala M, Simon MA, Gorcsan J. The Prognostic Value of Right Atrial Strain Imaging in Patients with Precapillary Pulmonary Hypertension. Journal of the American Society of Echocardiography. 2021;34(8):851-861.e1. doi:10.1016/j.echo.2021.03.007.