Key result
Right ventricular failure in pulmonary arterial hypertension carries high morbidity and mortality despite current medical and surgical treatment options, requiring new strategies for early detection.
This review highlights the pathophysiology, imaging assessment, prognosis, and treatment options for right ventricular failure in patients with pulmonary arterial hypertension.
Underscores need for vigilant RV monitoring in PAH; leaves open validation of early-detection strategies in prospective studies.
Right ventricular failure (RVF) remains the primary cause of death in patients with pulmonary arterial hypertension. We review the pathophysiology of RVF, including the remodeling and ventriculoarterial uncoupling that occurs when the failing right side of the heart is unable to compensate for a rising afterload. Secondly, the noninvasive imaging techniques used in the assessment of RVF are explored, including echocardiography, cardiac magnetic resonance imaging, computed tomography, and positron emission tomography. Third, we describe how these imaging techniques and a patient’s clinical characteristics may be used to determine prognosis. Lastly, we explore the medical and surgical/interventional treatment options for RVF. Despite these treatment options, morbidity and mortality remain high in this patient population. The discovery of new prognostic indicators, use of hybrid imaging for early detection of RVF, and strategies to prevent the development of RVF will be important if outcomes in this patient population are to improve.
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Mandras et al. (2015) conducted a review in Right ventricular failure in pulmonary arterial hypertension. Right ventricular failure in pulmonary arterial hypertension carries high morbidity and mortality despite current medical and surgical treatment options, requiring new strategies for early detection.
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