Diagnosing and treating the failing right heart

Curr Opin Cardiol. 2015 May;30(3):292-300. doi: 10.1097/HCO.0000000000000164.

Abstract

Purpose of review: Right ventricular failure (RVF) is associated with significant morbidity and mortality. There is an increasing interest in proper assessment of right ventricle (RV) function as well as understanding mechanisms behind RVF.

Recent findings: Within this article, we discuss the metabolic changes that occur in the RV in response to RVF, in particular, a shift toward glycolysis and increased glutaminolysis. We will detail the advances made in noninvasive imaging in assessing the function of the RV and review the methods to assess right ventricle-pulmonary artery coupling. We lastly investigate the role of new treatment options in the failing RV, such as β-blocker therapy.

Summary: RVF is a complicated entity. Although some inferences on RV function and treatment can be made from our understanding of the left ventricle, the RV has unique features, anatomically, metabolically and embryologically, that require dedicated RV-directed research.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Cardiac Catheterization
  • Echocardiography
  • Glucose / metabolism
  • Glutamine / metabolism
  • Glycolysis
  • Heart Failure / diagnosis*
  • Heart Failure / drug therapy
  • Heart Failure / metabolism
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / metabolism
  • Heart Ventricles / physiopathology
  • Humans
  • Magnetic Resonance Imaging
  • Pulmonary Artery
  • Ventricular Dysfunction, Right / diagnosis*
  • Ventricular Dysfunction, Right / drug therapy
  • Ventricular Dysfunction, Right / metabolism

Substances

  • Adrenergic beta-Antagonists
  • Glutamine
  • Glucose