How to measure pulmonary vascular and right ventricular function

Long-standing pulmonary hypertension causes significant peripheral and proximal arterial remodeling and right ventricular dysfunction. The clinical metric most often used to assess the progression of PH is the pulmonary vascular resistance (PVR). However, even when measured from multipoint pressure-flow curves, PVR provides information only on the peripheral arterial function, not the proximal arterial function and gives only an incomplete description of all the forces that oppose right ventricular (RV) flow output. Pulmonary vascular impedance spectra (PVZ) capture the impact of proximal and peripheral arterial structure and function on RV function. Analyses of ventricular-vascular coupling give insight into the efficiency of mechanical and metabolic interactions between the right ventricle and the pulmonary vasculature. Here we review techniques for measuring PVZ in humans and animal models and for determining RV function.