Dear reader,

For this november 2021 issue, I would like to recommend the paper “Multimodality imaging of the ischemic right ventricle: an overview and proposal of a diagnostic algorithm” by A. Malagoli et al. on behalf of the Working group of Echocardiography of the Italian Society of Cardiology [1]. They make the claim that there is no single imaging modality, that satisfies all the requirements of a complete description of the RV geometry and contractility. And for that reason, they wish to address the whole spectrum of the ischemic right ventricle through the available evidence on multimodality imaging. In addition, they propose a diagnostic algorithm, in order to reach a complete assessment of this chamber.

This overview starts off with a description of the pathophysiology of the ischemic right ventricle, followed by the diagnostic approaches using echocardiography, which remains the modality of choice in daily clinical practice, but the newer advanced imaging modalities, being magnetic resonance imaging and multi-slice CT, can provide additional information. A limitation in these assessments is of course the very thin wall of the right ventricle, and its particular shape, that is difficult to image. The Fig. 8 from their below describes the proposed diagnostic algorithm.

Fig. 8
figure 1

Diagnostic algorithm utilizing multimodality imaging in patients with myocardial infarct to assess the ischemic right ventricle: the Italian proposal. On the left, in green, left ventricular assessment; in the middle, in white, cardiac imaging modalities; on the right, in red, right ventricular assessment. MI myocardial infarct; LV left ventricular; RV right ventricular; 3D three-dimensional; STE speckle tracking; echocardiography; CMR cardiac magnetic resonance; MDCT multidetector computed tomography; ICD implantable cardioverter defibrillator; LVEF left ventricular ejection fraction

Full size image

I wish you much pleasure in reading this and the other papers in this issue of the International Journal of Cardiovascular Imaging.

Johan HC Reiber, PhD

Editor-in-chief