Evaluation and Management of Right-Sided Heart Failure

Published 12 April 2018

Marvin A. Konstam, Michael S. Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K. Kapur, Robb D. Kociol, Eldrin F. Lewis, Mandeep R. Mehra, Francis D. Pagani, Amish N. Raval, Carey Ward

Circulation. May 2018;137(20):e578-622

• Advanced Heart Failure & Transplantation
• Cardiology
• Endorsement
• Mechanical Circulatory Support
• Professional Guideline
• Publications & Journals
• Standards & Guidelines

Advances in pharmacology for managing pulmonary hypertension, and a mushrooming of both diagnostic techniques and durable and temporary mechanical circulatory support (MCS) devices have yielded expanded treatment options and enhanced outcomes in patients with acute and chronic disorders of the right side of the heart, which has led to a renewed interest  in investigating the right ventricle.

The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease.

This scientific statement review the causes and epidemiology of RV dysfunction, and the pathophysiology of acute and chronic RHF to provide guidance in the areas of pathophysiology of RVD, assessment and evaluation of RV function, epidemiology and prognosis of RHF, medical and surgical management of acute (ARHF) and chronic RHF (CRHF), and proposed areas for future investigation.

This document was endorsed by ISHLT in 2018.

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