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Purpose of Review <p>Explore the clinical progression, diagnostic challenges, and evolving treatments of systemic right ventricular (SRV) failure, highlighting key gaps and advances.</p> Recent Findings <p>Recent evidence highlights the distinct pathophysiology of SRV failure and limited efficacy of conventional heart failure (HF) treatments. Emerging drugs like SGLT2 inhibitors are being studied for modulating ventricular remodeling and fibrosis. Echocardiography, enhanced by speckle-tracking and 3D imaging, is first-line, while cardiac MRI remains the gold standard for volumetric, functional, and tissue characterization. SRV-specific machine learning models improve prognostication and personalized care. Advances in transcatheter tricuspid valve interventions offer less invasive options for high-risk patients. In end-stage SRV failure, ventricular assist devices effectively unload the ventricle, enhance transplant candidacy, may be combined with tricuspid procedures, and are increasingly used as long-term destination therapy.</p> Summary <p>SRV failure is a unique condition requiring personalized, multidisciplinary management, with advances in risk stratification and treatments shaping future care.</p>

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Evidence-based Management of Heart Failure in the Systemic Right Ventricle

  • 期刊论文

  • 发表日期：

    2025年10月9日

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  • Xander Jacquemyn,
  • Jef Van den Eynde,
  • Sruti Rao,
  • Shelby Kutty

摘要

Purpose of Review

Explore the clinical progression, diagnostic challenges, and evolving treatments of systemic right ventricular (SRV) failure, highlighting key gaps and advances.

Recent Findings

Recent evidence highlights the distinct pathophysiology of SRV failure and limited efficacy of conventional heart failure (HF) treatments. Emerging drugs like SGLT2 inhibitors are being studied for modulating ventricular remodeling and fibrosis. Echocardiography, enhanced by speckle-tracking and 3D imaging, is first-line, while cardiac MRI remains the gold standard for volumetric, functional, and tissue characterization. SRV-specific machine learning models improve prognostication and personalized care. Advances in transcatheter tricuspid valve interventions offer less invasive options for high-risk patients. In end-stage SRV failure, ventricular assist devices effectively unload the ventricle, enhance transplant candidacy, may be combined with tricuspid procedures, and are increasingly used as long-term destination therapy.

Summary

SRV failure is a unique condition requiring personalized, multidisciplinary management, with advances in risk stratification and treatments shaping future care.