Accessing the impact of Right Heart Adaptation on Myocardial Stiffness Using Natural Shear Wave Imaging

It is worth noting that clinical evidence in recent years has shown that changes in right ventricular function can serve as early indications of disease progression and risk stratification, hence predicting survival and long-term prognosis in patients with heart disease. Right heart adaptation refers to the structural, functional, and biomechanical changes that the right ventricle (RV) and right atrium undergo in response to increased workload, pressure overload, or volume overload. These adaptations can be physiological (compensatory) or pathological (maladaptive), depending on the underlying condition and the right heart’s ability to maintain its function. As right heart adaptation progresses, it potentially influences myocardial stiffness, and increased stiffness subsequently impairs both right and left heart function through ventricular interdependence. However, to the best of the our knowledge, limited research has focused on how right heart adaptation affects myocardial stiffness in both compensatory and maladaptive phases, and how these biomechanical changes influence left ventricular function through septal mechanics and pericardial constraint. Therefore, this PhD project aims to bridge this knowledge gap by investigating the impact of right heart adaptation on myocardial stiffness using natural shear wave imaging, with a focus on its implications for biventricular function and clinical outcomes.