Bibhuti B. Das, Shashi Raj
University of Mississippi Medical Center. Narayana Health.
United States and India
Journal of Heart and Lung Transplantation Open
JHLT Open 2025; 7:
DOI: 10.1016/j.jhlto.2024.100203
Abstract
Right ventricular failure (RVF) is a clinical syndrome resulting from structural and functional changes in the right ventricle (RV), leading to inadequate blood flow to the pulmonary circulation and elevated systemic venous pressures. Factors modulating RV function include afterload, preload, contractility, and interventricular dependency. The pathophysiology of RVF involves complex interactions, such as maladaptive hypertrophy, metabolic reprogramming, inflammation, fibrosis, apoptosis, and endothelial dysfunction. Therapeutic strategies are limited for RVF, as basic and clinical research has historically focused mainly on the left ventricle. Novel pharmacological interventions targeting metabolism, calcium homeostasis, oxidative stress, extracellular matrix remodeling, endothelial function, and inflammation are needed to address RVF effectively. This review explores the etiology, mechanisms, and pathophysiology of RVF, drugs directly targeting the RV myocardium, the intricate biological processes between RV and pulmonary vascular remodeling, surgical and device therapies, and future perspectives on managing RVF.
Category
Right Heart Dysfunction Associated with Pulmonary Vascular Disease
Review Articles Concerning Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes