Research Status and Prospect of Echocardiography in Evaluating Right Heart Dysfunction Related to ARDS

DOI: https://doi.org/10.62517/jmpe.202518402

Author(s)

Di Nie, ChunboYang*

Affiliation(s)

Department of Critical Care Medicine, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China *Corresponding Author

Abstract

Acute respiratory distress syndrome (ARDS) is a group of respiratory syndromes mainly characterized by acute hypoxic respiratory failure. The chest imaging shows diffuse infiltration shadows in both lungs, which cannot be fully explained by heart failure or fluid overload. During the pathophysiological process of ARDS, it often affects the right heart function of patients and is a predominant cause of death for critically ill patients. Right heart dysfunction related to ARDS significantly increases the risk of death for patients. Therefore, early and accurate identification and dynamic assessment of it are of great significance. Echocardiography, with its advantages of being non-invasive, real-time and operable at the bedside, has become a pivotal tool for accurately assessing right heart insufficiency related to ARDS. This article reviews the current situation of right heart dysfunction related to ARDS evaluated by echocardiography and looks forward to future research directions, with the aim of providing guidance for the monitoring and management of right heart function in ARDS patients.

Keywords

Acute Respiratory Distress Syndrome; Right Heart Insufficiency; Echocardiography; Research Status; Prospect

References

[1] Wang Wei, Xiang Boyu, Zhang Qianjiang, Sun Fei. Correlation analysis between serum SIRT1, ESM-1, FGF21 expression levels and treatment outcomes in patients with sepsis associated acute respiratory distress syndrome[J]. Journal of Clinical Medicine in Practice, 2025, 29(3): 46-50,56. [2] Han Hu, Zhang Litao, Xu Xin. Pathogens, drug resistance, and serum expression of ESM-1, sTREM-1, and MIP-1 α in pulmonary infections caused by acute respiratory distress syndrome[J]. Chinese Journal of Nosocomiology, 2025, 35(5): 647-651. [3] Yang P, Sjoding MW. Acute Respiratory Distress Syndrome: Definition, Diagnosis, and Routine Management[J]. Crit Care Clin, 2024, 40(2): 309-327. [4] Lyu Youkai, Ji Xiaoxia, Yun Tianqi. Study on the effect of ultrasound-guided VTI guided fluid resuscitation in the treatment of ARDS with right heart dysfunction[J]. China Journal of Emergeney Resuscitation and Disaster Medicine, 2025, 20(2): 207-211. [5] Petit M, Jullien E, Vieillard-Baron A. Right Ventricular Function in Acute Respiratory Distress Syndrome: Impact on Outcome, Respiratory Strategy and Use of Veno-Venous Extracorporeal Membrane Oxygenation[J]. Front Physiol, 2022, 14(12): 797252. [6] Jahngir MU, Nabizadeh-Eraghi P. Use of Right Ventricular Assisted Device for Right Heart Failure in a Patient With Acute Respiratory Distress Syndrome[J]. Cureus, 2021, 13(9): e17671. [7] Wu Changdong, Hou Ming, Yang Rong, et al. Diagnostic significance of combined detection of two-dimensional echocardiography, BNP, 6MWT, and MMRC for right heart dysfunction in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Chinese Journal of Lung Diseases (Electronic Edition), 2019,12(4): 441-444. [8] Wu Changdong, Hou Ming, Yang Rong, et al. Correlation between two-dimensional echocardiography, BNP, 6MWT, and mMRC in evaluating right heart dysfunction in AECOPD patients [J]. Chinese Journal of Clinical Research, 2020, 33(1): 27-30. [9] Giannakoulas G, Farmakis IT, Hobohm L, et al. Acute right ventricular failure: pathophysiology, aetiology, assessment, and management[J]. Eur Heart J, 2025, 46(26): 2520-2535. [10] Aqi, Wang Jingchao. Analysis of the predictive value of inflammatory factor levels in bronchoalveolar lavage fluid for the prognosis of patients with moderate to severe acute respiratory distress syndrome[J]. Chinese Journal of Medicine, 2025, 60(3): 305-307. [11] Pan Xiaodong, Cheng Jinglin. Value of two-dimensional speckle tissue tracking imaging technology in the assessment of right ventricular function in patients with acute respiratory distress syndrome[J]. Doctor, 2023, 8(5): 120-123. [12] Liu Xuesong, Xu Yonghao, Liu Dongdong, et al. Application of bedside ultrasound in high-risk pulmonary embolism in patients with severe pneumonia[J]. China Medicine and Pharmacy, 2021,11(12): 237-241. [13] Liu Xuesong, Zhang Rong, Xi Yin, Chen Sibei, Liu Xiaoqing, Li Yimin. Management of right heart dysfunction in severe ARDS patients treated with VV-ECMO[J]. International Journal of Respiration, 2020, 40(12): 904-910.