Predicting the Future RV Reserve in Cardiopulmonary Disease.pptx

1、,Predicting the Future:RV Reserve in Cardiopulmonary Disease,Claudia Baratto,MD,PhDDyspnea and Pulmonary Hypertension CenterDepartment of Cardiology,Ospedale S Luca IRCCS Istituto Auxologico ItalianoDepartment of Management,Information and Production Engineering,University of Bergamoc.barattoauxolog

2、ico.it,even endurance athletes can have“RV dysfunction”at rest!,La Gerche A,et al.J Am Soc Echocardiogr.2012;25:253;Cornwell et al.J Physiol 598.13(2020)pp 25752587,Although RV function may be low normal at rest,there is enormous RV functional reserve during exercise!,NON-ATHLETE,ATHLETE,RV reserve

3、tells the future,The RV contractile reserve is associated with VO2/exercise capacity,The RV contractile reserve is associated with prognosis,Right Ventricular Myofilament Dysfunction,Aslam MI,Hsu S.,et al.Eur J Heart Fail,2021 Feb;23(2):339-341;Hsu S,et al.Circulation.2018;137:23602370,Right Ventric

4、ular Myofilament Dysfunction,Aslam MI,Hsu S.,et al.Eur J Heart Fail,2021 Feb;23(2):339-341;Hsu S,et al.Circulation.2018;137:23602370,Failing RV:reduced Fmax(RV force-calcium curves in HF),RV-Fmax+28%IPAH-37%SSc-PAH,How to stress RV:,Drugs(dobutamine,sodium nitroprusside)PacingExercise:the most physi

5、ologic RV stressor,How to assess RV contractile reserve,Semplification/Availability/Practicity,Accuracy/Complexity/Tech progress,How to assess RV contractile reserve,Semplification/Availability/Practicity,Accuracy/Complexity/Tech progress,Hemodynamics at a glance,No established thresholdsPotential m

6、imickers(constriction,),The key is to assess RV reserve start simple,Echocardiography is the most studied modality for assessing RV contractile reserve,40%,Tello K,et al.Circ Cardiovasc Imaging.2019;Guo et al.Echocardiography.2019;La Gerche A,et al.J Am Soc Echocardiogr.2012;OroSiuba,JCF intersectio