RIGHT HEART REMODELING AND ITS EVALUATION IN THE CONTEMPORARY GUIDELINES OF ARTERIAL HYPERTENSION MANAGEMENT

Left ventricular structural and functional changes in patients with arterial hypertension were well established. However, the influence of arterial hypertension on right ventricular remodeling is still under investigation. The systematic assessment of right heart function, right ventricular size and geometry was lacking due to the underestimation of its meaning, complex shape and technical issues. Development of cardiovascular medicine, particularly improvement of cardiac imaging techniques, has revealed that the right ventricle has a vital role in a global cardiac function, cardiovascular and total morbidity and mortality. Clinical studies revealed an increased pulmonary vascular resistance in patients with arterial hypertension. Some studies showed that even early abnormal increase in arterial blood pressure may lead to the changes in right ventricular pressures, volumes and ejection fraction. It was confirmed by several studies, that influence of arterial hypertension is on the whole heart, namely hypertrophy of both ventricles mostly coexist, which strengthens the concept that the right and left ventricles physiologically represent a single functional unit. Hence, this phenotype can be considered as a very high cardiovascular risk profile. In spite of the clinical studies showed that the right ventricle plays an important role in the morbidity and mortality of patients with arterial hypertension, the term ?right heart? is not even mentioned in the world leading guidelines. Consequently, the purpose of this review article is to provide the overview of the current knowledge regarding the relationship between arterial hypertension and right ventricular structure, function, and its prognostic meaning.