Challenges and opportunities in assessing right ventricular structure and function: a Roadmap for standardization, clinical implementation and research

Kovács, A, Magunia, H, Nicoara, A, Oxborough, D, Keller, M, Augustine, DX, Thijssen, D, van Dijk, A, Denault, A, Haddad, F and Surkova, E (2025) Challenges and opportunities in assessing right ventricular structure and function: a Roadmap for standardization, clinical implementation and research. Nature Reviews Cardiology. pp. 1-18. ISSN 1759-5002

Text Challenges and opportunities in assessing right ventricular structure and function a Roadmap.pdf - Accepted Version Access Restricted until 25 December 2025. Download (1MB)

Abstract

Given its crucial role in determining patient symptoms and outcomes in various cardiopulmonary diseases, the thorough and accurate assessment of right ventricular function is essential for both diagnosis and ongoing patient monitoring. In the era of precision medicine, a more detailed characterization of patients with cardiopulmonary diseases is needed, especially with the emergence of novel pharmacological and device-based therapies, such as transcatheter tricuspid valve intervention, gene therapy in patients with cardiomyopathy and anti-obesity interventions for patients with heart failure. Precise and reproducible quantification of right ventricular morphology and function are crucial for risk stratification, the selection of different therapies for the appropriate patients and the evaluation of treatment outcomes. As our understanding of right ventricular pathophysiology expands, the need for sensitive markers of functional deterioration, reliable prognostic indicators and more precise surrogates for clinical trials becomes increasingly important. In this Roadmap, we address current challenges in the standardization of image acquisition, analysis and interpretation across different modalities. We explore the factors limiting the clinical adoption of more advanced approaches and provide expert recommendations to overcome these barriers. Additionally, we outline potential next steps for incorporating parameters of right ventricular function as surrogate end points in multicentre clinical trials of new drugs or devices, and highlight new research opportunities, including the integration of artificial intelligence technologies. Finally, we issue a call for international collaboration on selected priority areas.

Item Type:	Article
Uncontrolled Keywords:	32 Biomedical and Clinical Sciences; 3201 Cardiovascular Medicine and Haematology; 3202 Clinical Sciences; Clinical Research; Bioengineering; Precision Medicine; Heart Disease; Cardiovascular; 4.2 Evaluation of markers and technologies; Cardiovascular; 3 Good Health and Well Being; Cardiovascular System & Hematology; 3201 Cardiovascular medicine and haematology
Subjects:	Q Science > QP Physiology R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Nature Research
Date of acceptance:	2 June 2025
Date Deposited:	17 Jul 2025 09:45
Last Modified:	17 Jul 2025 10:00
DOI or ID number:	10.1038/s41569-025-01180-9
URI:	https://researchonline.ljmu.ac.uk/id/eprint/26787

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