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Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions

  • Congenital Heart Disease (RA Krasuski and G Fleming, Section Editors)
  • Published:
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Abstract

Purpose of Review

This review aims to summarize the fundamentals of RV-PA coupling, its non-invasive means of measurement, and contemporary understanding of RV-PA coupling in cardiac surgery, cardiac interventions, and congenital heart disease.

Recent Findings

The need for more accessible clinical means of evaluation of RV-PA coupling has driven researchers to investigate surrogates using cardiac MRI, echocardiography, and right-sided pressure measurements in patients undergoing cardiac surgery/interventions, as well as patients with congenital heart disease. Recent research has aimed to validate these alternative means against the gold standard, as well as establish cut-off values predictive of morbidity and/or mortality. This emerging evidence lays the groundwork for identifying appropriate RV-PA coupling surrogates and integrating them into perioperative clinical practice.

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Authors and Affiliations

  1. Department of Anesthesiology, Duke University, 2301 Erwin Road, Box # 3094, Durham, NC, 27710, USA

    Crosby Culp, Jon Andrews, Katherine Wang Sun, Anne Cherry, Mihai Podgoreanu & Alina Nicoara

  2. Department of Bioengineering, University of Colorado, Aurora, CO, USA

    Kendall Hunter

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  1. Crosby Culp
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  2. Jon Andrews
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Contributions

All authors reviewed the manuscript -C.C.: Wrote the abstract, introduction, basics of RV-PA coupling, and RV dysfunction and failure. Created outline to establish overall content of article, provided editing and review of all sections. Created Table 1, Fig 1 A&B, Fig 2. Modified Fig 1 C&D and obtained permission. -J.A.: Authored the section on congenital heart disease. -K.S.: Created Tables 2 and 3 -K.H.: Provided insights into the mechanisms of RV-PA coupling and methods of measurement, assisted with creation of Fig 2C. -A.C.: Provided methodological guidance for evaluation of the literature, and synthesis of the body of literature examined. -M.P.: Reviewed content for accuracy and relevance, provided critique of analysis of the literature and suggested additional literature for inclusion. -A.N.: Authored sections alternative methods of assessing RV-PA coupling, RV-PA coupling in patients undergoing cardiac interventions, emerging information and conclusion. Combined all sections. Provided high-level direction, mentorship, and oversight of all sections. She also used her expertise in RV:PA coupling to ensure the article accurately reflects the fundamentals of RV:PA coupling relevant to the clinician, the latest research, and covered gaps in knowledge.

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Correspondence to Crosby Culp.

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The authors declare no competing interests.

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Jon Andrews reports personal fees from Wolters Kluwer Health, outside the submitted work. The other authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article contains a description of an ongoing study being performed by the authors involving human subjects, and a graphical depiction of the data obtained from a single patient. This study was approved by the Institutional Review Board at Duke University Hospital. All patients enrolled in the study signed informed consent forms according to institutional protocols approved through review in the Duke University Hospital System Human Research Protection Program.

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Culp, C., Andrews, J., Sun, K.W. et al. Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions. Curr Cardiol Rep (2024). https://doi.org/10.1007/s11886-024-02052-3

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