Purpose of Review

To discuss physiologic and methodologic advances in the echocardiographic assessment of right heart (RH) function, including the emergence of artificial intelligence (AI) and point-of-care ultrasound.

Recent Findings

Recent studies have highlighted the prognostic value of right ventricular (RV) longitudinal strain, RV end-systolic dimensions, and right atrial (RA) size and function in pulmonary hypertension and heart failure. While RA pressure is a central marker of right heart diastolic function, the recent emphasis on venous excess imaging (VExUS) has provided granularity to the systemic consequences of RH failure. Several methodological advances are also changing the landscape of RH imaging including post-processing 3D software to delineate the non-longitudinal (radial, anteroposterior, and circumferential) components of RV function, as well as AI segmentation- and non-segmentation-based quantification. Together with recent guidelines and advances in AI technology, the field is shifting from specific RV functional metrics to integrated RH disease–specific phenotypes.

Summary

A modern echocardiographic evaluation of RH function should focus on the entire cardiopulmonary venous unit—from the venous to the pulmonary arterial system. Together, a multi-parametric approach, guided by physiology and AI algorithms, will help define novel integrated RH profiles for improved disease detection and monitoring.

Graphical Abstract: 

Advances in right heart echocardiography will incorporate a physiologic, multi-parametric approach that is augmented by deep learning to develop integrated right heart phenotypes. Ao Aorta, LV left ventricle, RA right atria, RV right ventricle, PA pulmonary artery

中文翻译：

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右心超声心动图评估：当前和未来的进展

审查目的

讨论右心 (RH) 功能超声心动图评估的生理学和方法学进展，包括人工智能 (AI) 和床旁超声的出现。

最近的发现

最近的研究强调了右心室 (RV) 纵向应变、RV 收缩末期尺寸以及右心房 (RA) 大小和功能在肺动脉高压和心力衰竭中的预后价值。虽然 RA 压力是右心舒张功能的核心标志，但最近对静脉过度成像 (VExUS) 的重视为 RH 衰竭的系统性后果提供了粒度。一些方法论的进步也正在改变 RH 成像的前景，包括用于描绘 RV 功能的非纵向（径向、前后和圆周）组成部分的后处理 3D 软件，以及基于 AI 分割和非分割的量化。结合最新的指南和人工智能技术的进步，该领域正在从特定的 RV 功能指标转向综合的 RH 疾病特定表型。

概括

现代超声心动图评估 RH 功能应关注整个心肺静脉单位——从静脉到肺动脉系统。总之，在生理学和人工智能算法指导下的多参数方法将有助于定义新颖的综合 RH 配置文件，以改进疾病检测和监测。

图形概要： 

右心超声心动图的进步将采用生理学多参数方法，通过深度学习增强右心综合表型。Ao 主动脉、LV 左心室、RA 右心房、RV 右心室、PA 肺动脉