Cor pulmonale: the role of traditional and advanced echocardiography in the acute and chronic settings
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Cor pulmonale: the role of traditional and advanced echocardiography in the acute and chronic settings Giulia Elena Mandoli 1 & Carlotta Sciaccaluga 1 & Francesco Bandera 2 & Paolo Cameli 3 & Roberta Esposito 4 & Antonello D’Andrea 5 & Vincenzo Evola 6 & Regina Sorrentino 4 & Alessandro Malagoli 7 & Nicolò Sisti 1 & Dan Nistor 8 & Ciro Santoro 4 & Elena Bargagli 3 & Sergio Mondillo 1 & Maurizio Galderisi 4 & Matteo Cameli 1 & on behalf of Working group of Echocardiography of Italian Society of Cardiology (SIC)
# The Author(s) 2020
Abstract Cor pulmonale is the condition in which the right ventricle undergoes morphological and/or functional changes due to diseases that affect the lungs, the pulmonary circulation, or the breathing process. Depending on the speed of onset of the pathological condition and subsequent effects on the right ventricle, it is possible to distinguish the acute cor pulmonale from the chronic type of disease. Echocardiography plays a central role in the diagnostic and therapeutic work-up of these patients, because of its noninvasive nature and wide accessibility, providing its greatest usefulness in the acute setting. It also represents a valuable tool for tracking right ventricular function in patients with cor pulmonale, assessing its stability, deterioration, or improvement during follow-up. In fact, not only it provides parameters with prognostic value, but also it can be used to assess the efficacy of treatment. This review attempts to provide the current standards of an echocardiographic evaluation in both acute and chronic cor pulmonale, focusing also on the findings present in the most common pathologies causing this condition. Keywords Cor pulmonale . Pulmonary hypertension . Right heart failure . Echocardiography . Right ventricular dysfunction
Background Cor pulmonale can be defined as the clinical setting in which the right side of the heart, in particular the right ventricle (RV), is affected by a pressure overload that induces changes of RV function and morphology. Depending on the duration of time in which the increased RV afterload is established, it is possible to distinguish an acute cor pulmonale from a chronic form of the disease. The most common condition responsible for the acute
* Giulia Elena Mandoli [email protected] 1
Department of Medical Biotechnologies, Division of Cardiology, AOUS Policlinico Santa Maria alle Scotte, University of Siena, Viale Bracci 1, 53100 Siena, Italy
2
Cardiology University Department, Heart Failure Unit, IRCCS, Policlinico San Donato, San Donato Milanese and Department of Biomedical Sciences for Health, University of Milano, Milan, Italy
3
Respiratory Diseases Unit, Department of Medical and Surgical Sciences and Neuroscience, University of Siena, Siena, Italy
4
Department of Advanced Biomedical Science, Federico II University Hospital Naples, Naples, Italy
type is acute pulmonary embolism (APE), whereas the chronic cor pulmonale is usually caused by chronic obstructive pulmonary disease (COPD) [1], followed by idiopathic p
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