Forgotten no More -- the Role of Right Ventricular Dysfunction in Heart Failure with Reduced Ejection Fraction. An Echocardiographic Perspective

While most attention in cardiovascular disease has been traditionally focused on the morphology, function and prognostic role of the left ventricle, during the last decade studies have raised awareness of the crucial role that the right ventricle plays in a variety of cardiovascular settings, including diseases primarily linked to the left ventricle. The assessment of right ventricular performance with conventional echocardiography is challenging. Novel echocardiographic techniques improve the functional assessment of the right ventricle and they showed good correlation with the gold standard represented by cardiovascular magnetic resonance. However, there is no single universally accepted parameter that accurately defines right ventricular function; hence a thorough evaluation of the right ventricle needs an integrative, multi-parametric approach. This review summarizes the traditional and innovative echocardiographic techniques used in the functional assessment of the right ventricle, focusing on the role of right ventricular dysfunction in heart failure with reduced ejection fraction and providing a perspective on recent evidence from literature.