Author + information
- Received March 25, 2018
- Revision received May 17, 2018
- Accepted May 30, 2018
- Published online October 10, 2018.
- Myriam Amsallem, MD, MSa,b,c,d,
- Olaf Mercier, MD, PhDd,e,
- Yukari Kobayashi, MDa,b,
- Kegan Moneghetti, MBBS (hons)a,b and
- Francois Haddad, MDa,b,c,∗ ()
- aDivision of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
- bStanford Cardiovascular Institute, Stanford, California
- cVera Moulton Wall Center at Stanford, Stanford, California
- dResearch and Innovation Unit, INSERM U999, DHU Torino, Paris Sud University, Marie Lannelongue Hospital, Le Plessis Robinson, France
- eDepartment of Cardiothoracic Surgery, Marie Lannelongue Hospital, Le Plessis Robinson, France
- ↵∗Address for correspondence:
Dr. Francois Haddad, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94304.
In the last decade, there has been renewed interest in the study of the right ventricle. It is now well established that right ventricular function is a strong predictor of mortality, not only in heart failure but also in pulmonary hypertension, congenital heart disease, and cardiothoracic surgery. The right ventricle is part of a cardiopulmonary unit with connections to the pulmonary circulation, venous return, atria, and left ventricle. In this context, ventriculoarterial coupling, interventricular interactions, and pericardial constraint become important to understand right ventricular adaptation to injury or abnormal loading conditions. This state-of-the-art review summarizes major advances that occurred in the field of right ventricular research over the last decade. The first section focuses on right ventricular physiology and pulmonary circulation. The second section discusses the emerging data on right ventricular phenotyping, highlighting the importance of myocardial deformation (strain) imaging and assessment of end-systolic dimensions. The third section reviews recent clinical trials involving patients at risk for or with established right ventricular failure, focusing on beta blockade, phosphodiesterase inhibition, and mechanical support of the failing right heart. The final section presents a perspective on active areas of research that are most likely to translate in clinical practice in the next decade.
Drs. Amsallem, Mercier, and Haddad are supported by a public grant overseen by the French National Research Agency as part of the second Investissements d’Avenir program (ANR-15-RHUS-0002). This work is also supported by funding from the Vera Moulton Center for Pulmonary Vascular Disease. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 25, 2018.
- Revision received May 17, 2018.
- Accepted May 30, 2018.
- 2018 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.