Invasive Right Ventricular Pressure-Volume Analysis: Basic Principles, Clinical Applications, and Practical Recommendations

Michael I. Brener, Amirali Masoumi, Vivian G. Ng, Khodr Tello, Marcelo B. Bastos, William K. Cornwell, Steven Hsu, Ryan J. Tedford, Philipp Lurz, Karl Philipp Rommel, Karl Patrik Kresoja, Sherif F. Nagueh, Manreet K. Kanwar, Navin K. Kapur, Gurumurthy Hiremath, Mohammad Sarraf, Antoon J.M. Van Den Enden, Nicolas M. Van Mieghem, Paul M. Heerdt, Rebecca T. HahnSusheel K. Kodali, Gabriel T. Sayer, Nir Uriel, Daniel Burkhoff

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Right ventricular pressure-volume (PV) analysis characterizes ventricular systolic and diastolic properties independent of loading conditions like volume status and afterload. While long-considered the gold-standard method for quantifying myocardial chamber performance, it was traditionally only performed in highly specialized research settings. With recent advances in catheter technology and more sophisticated approaches to analyze PV data, it is now more commonly used in a variety of clinical and research settings. Herein, we review the basic techniques for PV loop measurement, analysis, and interpretation with the aim of providing readers with a deeper understanding of the strengths and limitations of PV analysis. In the second half of the review, we detail key scenarios in which right ventricular PV analysis has influenced our understanding of clinically relevant topics and where the technique can be applied to resolve additional areas of uncertainty. All told, PV analysis has an important role in advancing our understanding of right ventricular physiology and its contribution to cardiovascular function in health and disease.

Original languageEnglish (US)
Pages (from-to)E009101
JournalCirculation: Heart Failure
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2022

Bibliographical note

Funding Information:
Dr Tello has received speaking fees from Actelion and Bayer. Dr Bastos receives personal fees from PulseCath BV. Dr Cornwell reports consulting fees and research funding from Medtronic. Dr Tedford reports no direct conflicts of interest related to this article but notes the following general disclosures: consulting relationships with Medtronic, Abbott, Aria CV Inc, Acceleron, Itamar, Edwards LifeSciences, Eidos Therapeutics, Lexicon Pharmaceuticals, Gradient, and United Therapeutics. Dr Hsu is on a steering committee for Medtronic, Acceleron, and Abbott, as well as a research advisory board for Abiomed, and also does hemodynamic core lab work for Actelion and Merck. Dr Kanwar is on the Abiomed advisory board. Dr Van Mieghem reports research grant support from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, PulseCAth BV, Abiomed, and Daiichi Sankyo. Dr Hiremath is a consultant for Abbott, B.Braun, Merit, and KA Medical. Dr Kapur reports institutional research grants and speaker/consulting honoraria from Abbott, Abiomed, Boston Scientific, Getinge, Medtronic, LivaNova, MDStart, preCARDIA, and Zoll. Dr Hahn has served as a consultant for Abbott Vascular, Abbott Structural, NaviGate, Philips Healthcare, Medtronic, Edwards Lifesciences, and GE Healthcare; is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-supported trials, for which she receives no direct industry compensation; has received speaker fees from Boston Scientific and Baylis Medical; and has received nonfinancial support from 3mensio. Dr Kodali has served on the scientific advisory board for Microinterventional Devices, Dura Biotech, Thubrikar Aortic Valve, and Supira; has served as a consultant for Meril Lifesciences, Admedus, Medtronic, and Boston Scientific; has served on the steering committee for Edwards Lifesciences and Abbott Vascular; has received honoraria from Meril Lifesciences, Admedus, Abbott Vascular, and Dura Biotech; and owns equity in Dura Biotech, Thubrikar Aortic Valve, Supira, and MID. Dr Sayer reports consulting fees from Abbott. Dr Uriel reports consulting fees from Medtronic and has received honorarium from Abbott. Dr Burkhoff discloses consulting fees from PVLoops and Cardiodyme and has received grant support from Abiomed. The other authors report no conflicts.

Funding Information:
Dr Brener is supported by the National Heart, Lung, and Blood Institute (T32HL007343) and the American College of Cardiology/Merck Research Fellowship.

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • heart failure
  • hemodynamics
  • pulmonary circulation
  • ventricular function, right

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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