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Review
. 2023 Jul;28(4):1009-1022.
doi: 10.1007/s10741-022-10276-0. Epub 2022 Nov 16.

Right heart failure in left heart disease: imaging, functional, and biochemical aspects of right ventricular dysfunction

Stefano Ghio  1 , Mauro Acquaro  2   3 , Piergiuseppe Agostoni  4   5 , Giuseppe Ambrosio  6 , Erberto Carluccio  6 , Vincenzo Castiglione  7   8 , Davide Colombo  2   3 , Michele D'Alto  9 , Santo Delle Grottaglie  10   11 , Frank Lloyd Dini  12 , Michele Emdin  7   8 , Martino Fortunato  13 , Andrea Igoren Guaricci  14 , Francesca Jacoangeli  6 , Alberto M Marra  15 , Stefania Paolillo  16   17 , Sivia Papa  18 , Luca Vicini Scajola  2   3 , Michele Correale #  19 , Alberto Palazzuoli #  20
Affiliations
Review

Right heart failure in left heart disease: imaging, functional, and biochemical aspects of right ventricular dysfunction

Stefano Ghio et al. Heart Fail Rev. 2023 Jul.

Abstract

For decades, cardiologists have largely underestimated the role of the right heart in heart failure due to left heart disease. Nowadays, the importance of evaluating right ventricular (RV) structure and function in left heart failure is well documented and this concept has been emphasized in the most recent heart failure guidelines. However, several relevant questions remain unanswered such as the following: (a) which imaging technique (standard or 3D echocardiography or strain imaging or cardiac magnetic resonance) and, more, which parameters should be used to grade the severity of RV dysfunction? (b) do less widespread and less applied diagnostic tools such as cardiopulmonary stress testing and bioelectrical impedance analysis play a role in this field? (c) are there specific biochemical aspects of RV failure? (d) why notion of pathophysiology of heart and lung interaction are so well appreciated at an academic level but are not applied in the clinical setting? The present review has been prepared by the Heart Failure (HF) working group of the Italian Society of Cardiology and its main objective is to improve our understanding on RV dysfunction in heart failure.

Keywords: Bioelectrical impedance analysis; Cardiac magnetic resonance; Echocardiography; Right heart catheterization; Right heart function; Strain.

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