Review of the Right Heart Masterclass on 123 Sonography and PH Echo Masterclass (access funded by Janssen)

Published 14/09/2022

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The Right Heart Masterclass module, delivered by 123 Sonography, was of interest to me as I wanted to build on my existing knowledge of pulmonary hypertension (PH). The online nature of the course allowed me to learn from the comfort of my home. The 15 British Society of Echocardiography (BSE) points were also very appealing!

I also attended the Janssen-supported PH Echo Masterclass – a face-to-face course that took place at the Golden Jubilee National Hospital (GJNH), Clydebank, Scotland.

By undertaking the two courses, I hoped to be able to identify and differentiate the types of PH, understand how PH develops and is detected and, ultimately, how PH is treated. The 123 Sonography course included twenty expert-led videos which contained very useful real-life examples. My main objective was to learn and introduce up-to-date theory into my department to raise awareness of the importance of echocardiography (echo) in detecting PH.

Both courses reinforced the importance of looking at the right heart to detect PH, particularly as the right heart can be forgotten during an echo, as well as the value of referring patients quickly to specialised centres for the early detection of PH, a rare and life-threatening disease.1 Patients with PH are often diagnosed too late, so early diagnosis and referral are paramount.

Diagnosing PH also involves taking a thorough medical history, medical examinations and, crucially, the ‘gold standard’ diagnostic tool, right heart catheterisation. Echo is a key non-invasive tool for identifying which patients require referral to a specialist centre for right heart catheterisation.2,3

Not all patients with PH have tricuspid regurgitation (TR), therefore it is important to estimate the right ventricular systolic pressure to avoid a diagnosis of PH being missed. The absence of TR does not mean the absence of PH.2

More subtle parameters that I am now more aware of and measuring routinely include:2,3

  1. Right ventricular outflow Doppler acceleration time <105 m/s and/or mid-systolic notching
  2. Early diastolic pulmonary regurgitation velocity >2.2 m/s
  3. Pulmonary artery diameter >25 mm
  4. Right ventricle/left ventricle basal diameter ratio >1.0
  5. Flattening of the intraventricular septum (left ventricular eccentricity index >1.1 in systole or both systole and diastole)
  6. Inferior vena cava diameter >21 mm with decreased inspiratory collapse (<50% with a sniff or <20% with quiet inspiration)
  7. Right atrial area (end systole) >18 cm2

A huge benefit of attending the Right Heart and PH Masterclass within the GJNH has been the support from colleagues within the specialist centre; Catherine Garioch, Shabana Ali, Dr Colin Church, Dr Helen Dormond and Fiona Russell (Janssen). In my hospital, useful guidelines have been produced and distributed to departments to aid in the assessment of PH with echo. As a sonographer, I certainly feel much more aware and more confident in the assessment of PH.

Ms Lindsay Kane
Chief Cardiac Physiologist, University Hospital Crosshouse

To learn more about courses available to you, please contact Fiona Russell ([email protected]).

Click here to view more details on the Right Heart Masterclass.

UK healthcare professionals can visit the Act on PAH website for more information on PH.


  1. Kiely D, et al. Eur Heart J Suppl. 2019;21:K9–20
  2. Augustine DX, et al. Echo Res Pract. 2018;5:G11–24
  3. Galiè N, et al. Eur Heart J. 2016;37:67–119

This content is published as part of a paid advertising agreement.

CP-339848 | September 2022