{"id":"cfeddff20224","type":"article","url":"https://hartvaat.nl/2026/10/01/multimodale-rechterhartmonitoring-biedt-kader-voor-hartfalenverloop-conceptueel-/","title":"Multimodale rechterhartmonitoring biedt kader voor hartfalenverloop — conceptueel overzicht","title_en":"From snapshot to trajectory: A multimodality right-heart monitoring framework across the heart failure spectrum.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"American heart journal plus : cardiology research and practice","doi":"10.1016/j.ahjo.2026.100881","source_url":"https://doi.org/10.1016/j.ahjo.2026.100881","authors":["Arif Albulushi","Mohammed Al Habsi","Amira Al-Kharusi"],"significance":4,"published":"2026-09-24","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/rechtsventrikelfalen/","https://hartvaat.nl/kennis/hartfalen/wat-is-hartfalen/"],"congress":"","summary_en":"This narrative review proposes a pragmatic framework for serial right-heart monitoring across the heart failure spectrum (HFrEF, HFmrEF, HFpEF). Rather than focusing solely on the left ventricle, the approach integrates clinical status, biomarkers, echocardiography, cardiac MRI, and selective invasive hemodynamics to track right ventricular dysfunction and pulmonary vascular load over time. While suggested reassessment intervals remain illustrative and unvalidated, the framework helps cardiologists identify discordance between clinical symptoms and right-heart trajectories, prompting timely escalation to advanced imaging or hemodynamic assessment.","created":"2026-09-18T00:54:26Z","updated":"2026-09-18T00:54:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Dit narratieve overzicht schetst een pragmatisch kader voor seriële rechterhartmonitoring bij patiënten met HFrEF, HFmrEF en HFpEF. In plaats van uitsluitend op het linkerhart te focussen, integreert de aanpak klinische status, biomarkers, echocardiografie, cardiac MRI en selectieve invasieve hemodynamiek om het verloop van rechterventriculaire dysfunctie en pulmonale weerstand in kaart te brengen. Hoewel de voorgestelde herhalingsintervallen illustratief en nog niet gevalideerd zijn, biedt het framework cardiologen een gestructureerde manier om discordantie tussen klinische symptomen en rechterharttrajecten op te sporen, wat tijdige doorverwijzing voor verdere diagnostiek kan rechtvaardigen.","abstract_original":"Right ventricular (RV) dysfunction, pulmonary vascular load, tricuspid regurgitation, and venous congestion are important determinants of symptoms and outcomes across the heart failure spectrum, yet longitudinal follow-up remains predominantly left ventricle-centered. This narrative review summarizes the physiological and multimodality imaging basis for serial right-heart assessment across HFrEF, HFmrEF, and HFpEF, using SGLT2 inhibition and dapagliflozin as a contemporary mechanistic example rather than the basis for a drug-specific monitoring algorithm. We propose a pragmatic, therapy-agnostic trajectory framework integrating clinical status, biomarkers, echocardiography, cardiac magnetic resonance, and selective invasive hemodynamics. The approach distinguishes RV dysfunction from overt right-heart failure, incorporates loading conditions, rhythm and tricuspid regurgitation phenotype, and prioritizes serial direction of change over isolated measurements. Emerging SGLT2 inhibitor data provide signals of favorable hemodynamic and RV-pulmonary arterial interaction in selected populations, although dedicated RV-focused randomized evidence remains limited. Suggested reassessment windows are illustrative rather than validated and should be individualized. This framework is intended to complement conventional heart failure assessment and support selective advanced imaging or hemodynamic clarification when clinical and right-heart trajectories are discordant."}