Figure 9.

Our approach to RV assessment in echocardiography is summarized. A measurement of size in the apical 4-chamber view evaluating minor and major right ventricular (RV) dimensions is reported, along with RV thickness from the subcostal window. Surrogate measures of RV function routinely evaluated include fractional area change (FAC), tricuspid annulus plane systolic excursion (TAPSE), myocardial performance index (MPI), and systolic velocity (S′), with others utilized in research or in times of measurement discrepancies. Comments about qualitative RV wall motion and the relationship between right and left ventricles, as evidenced by septal motion, are described. We highly recommend use of RV strain and three-dimensional (3D) RV assessment in all pulmonary arterial hypertension patients if the capability exists within the clinical setting. Recommended routine noninvasive hemodynamics that can be easily obtained include right ventricular systolic pressure (RVSP), central venous pressure (CVP), pulmonary artery acceleration time (PAAT), and pulmonary vascular resistance (PVR).