LAUSR

Functional adaptation of the right ventricle (RV) to its afterload plays an important prognostic role in pulmonary hypertension (PH) [1]. The preferred “multibeat” (MB) method for assessing RV–pulmonary vascular interaction involves the measurement of end-systolic elastance (Ees), the slope of the end-systolic pressure (ESP) to end-systolic volume over sequential heart beats with varying preload. The Ees value is then matched to simultaneous pulmonary arterial (PA) elastance at end systole (Ea), calculated as ESP pressure divided by stroke volume (SV). The ratio of Ees to Ea (Ees/Ea) is termed RV–PA coupling, preservation of which indicates maintenance RV functioning in the face of increasing afterload [1]. However, while the MB method is generally regarded as the reference standard, it requires continuous, accurate measurement of RV volume and is therefore not readily applicable in most clinical settings. Surrogates of right ventricle (RV) end-systolic pressure (ESP) used to determine RV–pulmonary artery coupling vary across studies. ESP using point of maximal time varying elastance provides most accurate estimate of actual ESP. https://bit.ly/3xuqX3B