Right ventricular dysfunction in HFpEF: an underrecognised driver of functional limitation and prognosis
F Chughtai, M E Ali, A Chamoun, T Farooq, S Batool, S Tameez-Ud-Din, M Yousaf, P Memon, M Ali, S Murad, M T Khan, M PanditAbstract
Introduction
Heart failure with preserved ejection fraction (HFpEF) accounts for half of all heart failure cases, with increasing evidence highlighting right ventricular (RV) dysfunction as a key contributor to functional limitations and adverse outcomes.
Objective
This review examines the pathophysiology, diagnosis, prognosis, and treatments for RV dysfunction in HFpEF, advocating for its inclusion in clinical evaluation and risk stratification.
Methods
A search of PubMed and Scopus (2015-2024) identified 74 studies on RV dysfunction in HFpEF, focusing on systematic reviews, meta-analyses, and original research.
Results
RV dysfunction occurs in 19-33% of HFpEF patients, worsening prognosis and increasing mortality, morbidity, and hospitalisations. Key mechanisms include RV-pulmonary artery uncoupling, impaired diastolic function, and comorbidities. Advanced imaging and echocardiographic indices aid diagnosis, while new treatments like SGLT2 inhibitors, interatrial shunt devices, and exercise training offer potential benefits.