The Right Heart International Network (RIGHT-NET): Rationale, Objectives,  Methodology, and Clinical Implications.

Echocardiography, Doppler/methods; Echocardiography, Stress/methods; Exercise/physiology; Female; Heart Ventricles/diagnostic imaging/physiopathology; Humans; Hypertension, Pulmonary/diagnostic imaging/physiopathology; Male; Prospective Studies; Pulmonary Circulation/physiology; Research Design; Ventricular Function, Right/physiology; Exercise doppler echocardiography; Pulmonary circulation; Pulmonary hypertension; Right heart

Abstract :

[en] The Right Heart International Network is a multicenter international study aiming to prospectively collect exercise Doppler echocardiography tests of the right heart pulmonary circulation unit (RHPCU) in large cohorts of healthy subjects, elite athletes, and individuals at risk of or with overt pulmonary hypertension. It is going to provide standardization of exercise stress echocardiography of RHPCU and explore the full physiopathologic response.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Ferrara, Francesco; Heart Department, University Hospital of Salerno, Salerno, Italy.

Gargani, Luna; Institute of Clinical Physiology-C.N.R., Pisa, Italy.

Armstrong, William F; Division of Cardiovascular Medicine, University of Michigan Medical Center, Ann

Agoston, Gergely; Department of Family Medicine, University of Szeged, Szeged, Hungary.

Cittadini, Antonio; Department of Translational Medical Sciences, University Federico II, Naples,

Citro, Rodolfo; Heart Department, University Hospital of Salerno, Salerno, Italy.

D'Alto, Michele; Department of Cardiology, University of Campania "Luigi Vanvitelli", Naples,

D'Andrea, Antonello; Department of Cardiology, University of Campania "Luigi Vanvitelli", Naples,

Dellegrottaglie, Santo; Division of Cardiology, Ospedale Medico-Chirurgico Accreditato Villa dei Fiori,

De Luca, Nicola; Hypertension Research Center "CIRIAPA", Federico II University, Napoli, Italy.

More authors (26 more)

Language :

English

Title :

The Right Heart International Network (RIGHT-NET): Rationale, Objectives, Methodology, and Clinical Implications.

Publication date :

July 2018

Journal title :

Heart Failure Clinics

ISSN :

1551-7136

Publisher :

Saunders, Us

Volume :

Issue :

Pages :

443-465

Peer reviewed :

Peer reviewed

Commentary :

Available on ORBi :

since 25 May 2022

Statistics

Number of views

82 (0 by ULiège)

Number of downloads

126 (0 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

OpenAlex citations

Bibliography

Wood, P., Pulmonary hypertension with special reference to the vasoconstrictive factor. Br Heart J 20:4 (1958), 557–570.
Badesch, D.B., Champion, H.C., Sanchez, M.A., et al. Diagnosis and assessment of pulmonary arterial hypertension. J Am Coll Cardiol 54 (2009), S55–S66.
Hoeper, M.M., Bogaard, H.J., Condliffe, R., et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol 62:25suppl (2013), D45–D50.
Lewis, G.D., Bossone, E., Naeije, R., et al. Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation 128 (2013), 1470–1479.
Naeije, R., Vanderpool, R., Dhakal, B.P., et al. Exercise-induced pulmonary hypertension: physiological basis and methodological concerns. Am J Respir Crit Care Med 187 (2013), 576–583.
Herve, P., Lau, E.M., Sitbon, O., et al. Criteria for diagnosis of exercise pulmonary hypertension. Eur Respir J 46 (2015), 728–737.
Naeije, R., Vonk Noordegraaf, A., Kovacs, G., Exercise-induced pulmonary hypertension: at last!. Eur Respir J 46 (2015), 583–586.
Naeije, R., Saggar, R., Badesch, D., et al. Exercise-induced pulmonary hypertension. Translating pathophysiological concepts into clinical practice. Chest, 2018 [Epub ahead of print].
Kovacs, G., Herve, P., Barbera, J.A., et al. An official European Respiratory Society statement: pulmonary haemodynamics during exercise. Eur Respir J, 50(5), 2017 [pii:1700578].
D'Alto, M., Pavelescu, A., Argiento, P., et al. Echocardiographic assessment of right ventricular contractile reserve in healthy subjects. Echocardiography 34 (2017), 61–68.
Claessen, G., La Gerche, A., Voigt, J.U., et al. Accuracy of echocardiography to evaluate pulmonary vascular and RV function during exercise. JACC Cardiovasc Imaging 9:5 (2016), 532–543.
Galiè, N., Humbert, M., Vachiery, J.L., et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37:1 (2016), 67–119.
Ferrara, F., Gargani, L., Ostenfeld, E., et al. Imaging the right heart pulmonary circulation unit: Insights from advanced ultrasound techniques. Echocardiography 34:8 (2017), 1216–1231.
Bossone, E., Ferrara, F., Grünig, E., Echocardiography in pulmonary hypertension. Curr Opin Cardiol 30:6 (2015), 574–586.
Bossone, E., D'Andrea, A., D'Alto, M., et al. Echocardiography in pulmonary arterial hypertension: from diagnosis to prognosis. J Am Soc Echocardiogr 26:1 (2013), 1–14.
Rudski, L.G., Gargani, L., Armstrong, W.F., et al. Stressing the cardiopulmonary vascular system: the role of echocardiography. J Am Soc Echocardiogr, 2018 [Epub ahead of print].
Picano, E., Pellikka, P.A., Stress echo applications beyond coronary artery disease. Eur Heart J 35:16 (2014), 1033–1040.
Lancellotti, P., Pellikka, P.A., Budts, W., et al. The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 30:2 (2017), 101–138.
Himelman, R.B., Stulbarg, M., Kircher, B., et al. Noninvasive evaluation of pulmonary artery pressure during exercise bysaline-enhanced Doppler echocardiography in chronic pulmonary disease. Circulation 79 (1989), 863–871.
Oelberg, D.A., Mascotte, F., Kreisman, H., et al. Evaluation of right ventricular systolic atrial pressure during incremental exercise by Doppler echocardiography in adults with septal defect. Chest 113 (1998), 1459–1465.
Bossone, E., Rubenfire, M., Bach, D.S., et al. Range of tricuspid regurgitation velocity at rest and during exercise in normal adult men: Implications for the diagnosis of pulmonary hypertension. J Am Coll Cardiol 33 (1999), 1662–1666.
Grünig, E., Mereles, D., Hildebrandt, W., et al. Stress Doppler echocardiography for identification of susceptibility to high altitude pulmonary edema. J Am Coll Cardiol 35 (2000), 980–987.
Kiencke, S., Bernheim, A., Maggiorini, M., et al. Exercise-induced pulmonary artery hypertension: a rare finding?. J Am Coll Cardiol 51 (2008), 513–514.
Grünig, E., Weissmann, S., Ehlken, N., et al. Stress doppler echocardiography in relatives of patients with idiopathic and familial pulmonary arterial hypertension: results of a multicenter European analysis of pulmonary artery pressure response to exercise and hypoxia. Circulation 119 (2009), 1747–1757.
Mahjoub, H., Levy, F., Cassol, M., et al. Effects of age on pulmonary artery systolic pressure at rest and during exercise in normal adults. Eur J Echocardiogr 10:5 (2009), 635–640.
Möller, T., Brun, H., Fredriksen, P.M., et al. Right ventricular systolic pressure response during exercise in adolescents born with atrial or ventricular septal defect. Am J Cardiol 105 (2010), 1610–1616.
Argiento, P., Chesler, N., Mulè, M., et al. Exercise stress echocardiography for the study of the pulmonary circulation. Eur Respir J 35 (2010), 1273–1278.
La Gerche, A., MacIsaac, A.I., Burns, A.T., et al. Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise. J Appl Physiol (1985) 109:5 (2010), 1307–1317.
D'Alto, M., Ghio, S., D'Andrea, A., et al. Inappropriate exercise-induced increase in pulmonary artery pressure in patients with systemic sclerosis. Heart 97 (2011), 112–117.
Argiento, P., Vanderpool, R.R., Mulè, M., et al. Exercise stress echocardiography of the pulmonary circulation: limits of normal and sex differences. Chest 142:5 (2012), 1158–1165.
Lalande, S., Yerly, P., Faoro, V., et al. Pulmonary vascular distensibility predicts aerobic capacity in healthy individuals. J Physiol (1985) 590 (2012), 4279–4288.
Simaga, B., Vicenzi, M., Faoro, V., et al. Pulmonary vascular function and exercise capacity in black sub-Saharan Africans. J Appl Physiol 119 (2015), 502–507.
Forton, K., Motoji, Y., Deboeck, G., et al. Effects of body position on exercise capacity and pulmonary vascular pressure-flow relationships. J Appl Physiol 121 (2016), 1145–1150.
Faoro, V., Deboeck, G., Vicenzi, M., et al. Pulmonary vascular function and aerobic exercise capacity at moderate altitude. Med Sci Sports Exerc 49 (2017), 2131–2138.
Motoji, Y., Forton, K., Pezzuto, B., et al. Resistive or dynamic exercise stress testing of the pulmonary circulation and the right heart. Eur Respir J, 50(1), 2017 [pii:1700151].
Bidart, C.M., Abbas, A.E., Parish, J.M., et al. The noninvasive evaluation of exercise-induced changes in pulmonary artery pressure and pulmonary vascular resistance. J Am Soc Echocardiogr 20:3 (2007), 270–275.
Rodríguez, D.A., Sancho-Muñoz, A., Rodó-Pin, A., et al. Right ventricular response during exercise in patients with chronic obstructive pulmonary disease. Heart Lung Circ 26:6 (2017), 631–634.
Ait-Ali, L., Siciliano, V., Passino, C., et al. Role of stress echocardiography in operated fallot: feasibility and detection of right ventricular response. J Am Soc Echocardiogr 27:12 (2014), 1319–1328.
Brenner, R., Pratali, L., Rimoldi, S.F., et al. Exaggerated pulmonary hypertension and right ventricular dysfunction in high-altitude dwellers with patent foramen ovale. Chest 147:4 (2015), 1072–1079.
van Riel, A.C., de Bruin-Bon, R.H., Gertsen, E.C., et al. Simple stress echocardiography unmasks early pulmonary vascular disease in adult congenital heart disease. Int J Cardiol 197 (2015), 312–314.
Stuber, T., Sartori, C., Schwab, M., et al. Exaggerated pulmonary hypertension during mild exercise in chronic mountain sickness. Chest 137:2 (2010), 388–392.
Groepenhoff, H., Overbeek, M.J., Mulè, M., et al. Exercise pathophysiology in patients with chronic mountain sickness. Chest 142 (2012), 877–884.
Pratali, L., Allemann, Y., Rimoldi, S.F., et al. RV contractility and exercise-induced pulmonary hypertension in chronic mountain sickness: a stress echocardiographic and tissue Doppler imaging study. JACC Cardiovasc Imaging 6:12 (2013), 1287–1297.
Collins, N., Bastian, B., Quiqueree, L., et al. Abnormal pulmonary vascular responses in patients registered with a systemic autoimmunity database: pulmonary hypertension assessment and screening evaluation using stress echocardiography (PHASE-I). Eur J Echocardiogr 7 (2006), 439–446.
Alkotob, M.L., Soltani, P., Sheatt, M.A., et al. Reduced exercise capacity and stress-induced pulmonary hypertension in patients with sclerodermia. Chest 130 (2006), 176–181.
Steen, V., Chou, M., Shanmugam, V., et al. Exercise-induced pulmonary arterial hypertension in patients with systemic sclerosis. Chest 134 (2008), 146–151.
Reichenberger, F., Voswinckel, R., Schulz, R., et al. Noninvasive detection of early pulmonary vascular dysfunction in scleroderma. Respir Med 103 (2009), 1713–1718.
Kovacs, G., Maier, R., Aberer, E., et al. Assessment of pulmonary arterial pressure during exercise in collagen vascular disease: echocardiography versus right heart catheterisation. Chest 138:2 (2010), 270–278.
Gargani, L., Pignone, A., Agoston, G., et al. Clinical and echocardiographic correlations of exercise-induced pulmonary hypertension in systemic sclerosis: a multicenter study. Am Heart J 165:2 (2013), 200–207.
Grünig, E., Tiede, H., Enyimayew, E.O., et al. Assessment and prognostic relevance of right ventricular contractile reserve in patients with severe pulmonary hypertension. Circulation 128 (2013), 2005–2015.
Codullo, V., Caporali, R., Cuomo, G., et al. Stress doppler echocardiography in systemic sclerosis: evidence for a role in the prediction of pulmonary hypertension. Arthritis Rheum 65 (2013), 2403–2411.
Voilliot, D., Magne, J., Dulgheru, R., et al. Determinants of exercise-induced pulmonary arterial hypertension in systemic sclerosis. Int J Cardiol 173 (2014), 373–379.
Nagel, C., Henn, P., Ehlken, N., et al. Stress Doppler echocardiography for early detection of systemic sclerosis-associated pulmonary arterial hypertension. Arthritis Res Ther, 17, 2015, 165.
Kovacs, G., Avian, A., Wutte, N., et al. Changes in pulmonary exercise haemodynamics in scleroderma: a 4-year prospective study. Eur Respir J, 50(1), 2017 [pii:1601708].
Lancellotti, P., Troisfontaines, P., Toussaint, A.C., et al. Prognostic importance of exercise-induced changes in mitral regurgitation in patients with chronic ischemic left ventricular dysfunction. Circulation 108 (2003), 1713–1717.
Tumminello, G., Lancellotti, P., Lempereur, M., et al. Determinants of pulmonary artery hypertension at rest and during exercise in patients with heart failure. Eur Heart J 28 (2007), 569–574.
Ennezat, P.V., Marechaux, S., Huerre, C., et al. Exercise does not enhance the prognostic value of Doppler echocardiography in patients with left ventricular systolic dysfunction and functional mitral regurgitation at rest. Am Heart J 155 (2008), 752–757.
Marechaux, S., Pincon, C., Le Tourneau, T., et al. Cardiac correlates of exercise induced pulmonary hypertension in patients with chronic heart failure due to left ventricular systolic dysfunction. Echocardiography 25 (2008), 386–393.
Bandera, F., Generati, G., Pellegrino, M., et al. Role of right ventricle and dynamic pulmonary hypertension on determining ΔVO2/Δ Work Rate flattening: insights from cardiopulmonary exercise test combined with exercise echocardiography. Circ Heart Fail 7:5 (2014), 782–790.
Guazzi, M., Villani, S., Generati, G., et al. Right ventricular contractile reserve and pulmonary circulation uncoupling during exercise challenge in heart failure: pathophysiology and clinical phenotypes. JACC Heart Fail 4:8 (2016), 625–635.
Magne, J., Lancellotti, P., Pierard, L.A., Exercise pulmonary hypertension in asymptomatic degenerative mitral regurgitation. Circulation 122 (2010), 33–41.
Kusunose, K., Popović, Z.B., Motoki, H., et al. Prognostic significance of exercise-induced right ventricular dysfunction in asymptomatic degenerative mitral regurgitation. Circ Cardiovasc Imaging 6:2 (2013), 167–176.
Lancellotti, P., Magne, J., Donal, E., et al. Determinants and prognostic significance of exercise pulmonary hypertension in asymptomatic severe aortic stenosis. Circulation 126 (2012), 851–859.
Brochet, E., Détaint, D., Fondard, O., et al. Early hemodynamic changes versus peak values: what is more useful to predict occurrence of dyspnea during stress echocardiography in patients with asymptomatic mitral stenosis?. J Am Soc Echocardiogr 24:4 (2011), 392–398.
Kovacs, G., Olschewski, A., Berghold, A., et al. Pulmonary vascular resistance during exercise: a systematic review. Eur Respir J 39 (2012), 319–328.
Oliveira, R.K., Agarwal, M., Tracy, J.A., et al. Age-related upper limits of normal for maximum upright exercise pulmonary haemodynamics. Eur Respir J 47 (2016), 1179–1188.
D'Alto, M., Romeo, E., Argiento, P., et al. Accuracy and precision of echocardiography versus right heart catheterization for the assessment of pulmonary hypertension. Int J Cardiol 168 (2013), 4058–4062.
van Riel, A.C., Opotowsky, A.R., Santos, M., et al. Accuracy of echocardiography to estimate pulmonary artery pressures with exercise: a simultaneous invasive-noninvasive comparison. Circ Cardiovasc Imaging, 10(4), 2017 [pii:e005711].
Ferrara, F., Rudski, L.G., Vriz, O., et al. Physiologic correlates of tricuspid annular plane systolic excursion in 1168 healthy subjects. Int J Cardiol 223 (2017), 736–743.
Morganroth, J., Maron, B.J., Henry, W.L., et al. Comparative left ventricular dimensions in trained athletes. Ann Intern Med 82 (1975), 521–524.
D'Andrea, A., Formisano, T., Riegler, L., et al. Acute and chronic response to exercise in athletes: the “supernormal heart.”. Adv Exp Med Biol 999 (2017), 21–41.
Pelliccia, A., Caselli, S., Sharma, S., et al. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart. Eur Heart J, 2017 [Epub ahead of print].
Galderisi, M., Cardim, N., D'Andrea, A., et al. The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 16(4), 2015, 353.
D'Andrea, A., Naeije, R., D'Alto, M., et al. Range in pulmonary artery systolic pressure among highly trained athletes. Chest 139:4 (2011), 788–794.
Galderisi, M., Cosyns, B., Edvardsen, T., et al. 2016–2018 EACVI Scientific Documents Committee, 2016–2018 EACVI Scientific Documents Committee. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 18:12 (2017), 1301–1310.
Rudski, L.G., Lai, W.W., Afilalo, J., et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23 (2010), 685–713.
Lang, R.M., Badano, L.P., Mor-Avi, V., et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28 (2015), 1–39.
Nagueh, S.F., Smiseth, O.A., Appleton, C.P., et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 29:4 (2016), 277–314.
Sicari, R., Nihoyannopoulos, P., Evangelista, A., et al., European Association of Echocardiography. Stress echocardiography expert consensus statement–executive summary: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur Heart J 30:3 (2009), 278–289.
Popescu, B.A., Stefanidis, A., Nihoyannopoulos, P., et al. Updated standards and processes for accreditation of echocardiographic laboratories from the European association of cardiovascular imaging: an executive summary. Eur Heart J Cardiovasc Imaging 15:11 (2014), 1188–1193.
Galderisi, M., Henein, M.Y., D'hooge, J., et al. European Association of echocardiography. Recommendations of the European Association of Echocardiography: how to use echo-Doppler in clinical trials: different modalities for different purposes. Eur J Echocardiogr 12:5 (2011), 339–353.
Tolle, J.J., Waxman, A.B., Van Horn, T.L., et al. Exercise-induced pulmonary arterial hypertension. Circulation 118 (2008), 2183–2189.
Blumberg, F.C., Arzt, M., Lange, T., et al. Impact of right ventricular reserve on exercise capacity and survival in patients with pulmonary hypertension. Eur J Heart Fail 15 (2013), 771–775.
Condliffe, R., Kiely, D.G., Peacock, A.J., et al. Connective tissue disease–associated pulmonary arterial hypertension in the modern treatment era. Am J Respir Crit Care Med 179 (2009), 151–157.
Saggar, R., Khanna, D., Furst, D.E., et al. Exercise-induced pulmonary hypertension associated with systemic sclerosis: four distinct entities. Arthritis Rheum 62 (2010), 3741–3750.
Hinderhofer, K., Fischer, C., Pfarr, N., et al. Identification of a new intronic BMPR2-mutation and early diagnosis of heritable pulmonary arterial hypertension in a large family with mean clinical follow-up of 12 years. PLoS One, 9(3), 2014, e91374.
Stamm, A., Saxer, S., Lichtblau, M., et al. Exercise pulmonary haemodynamics predict outcome in patients with systemic sclerosis. Eur Respir J 48 (2016), 1658–1667.