Skip to main content

Advertisement

SpringerLink
Log in

Right ventricular diastolic dysfunction and failure: a review

  • Published:
Heart Failure Reviews Aims and scope Submit manuscript

Abstract

Right ventricular diastolic dysfunction and failure (RVDDF) has been increasingly identified in patients with cardiovascular diseases, including heart failure and other diseases with cardiac involvement. It is unknown whether RVDDF exists as a distinct clinical entity; however, its presence and degree have been shown to be a sensitive marker of end-organ dysfunction related to multiple disease processes including systemic hypertension, pulmonary hypertension, heart failure, and endocrine disease. In this manuscript, we review issues pertaining to RVDDF including anatomic features of the right ventricle, physiologic measurements, RVDDF diagnosis, underlying mechanisms, clinical impact, and clinical management. Several unique features of RVDDF are also discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sanz J, Sanchez-Quintana D, Bossone E, Bogaard HJ, Naeije R (2019) Anatomy, function, and dysfunction of the right ventricle: JACC state-of-the-art review. J Am Coll Cardiol 73:1463–1482

    Article  PubMed  Google Scholar 

  2. Vonk-Noordegraaf A, Haddad F, Chin KM, Forfia PR, Kawut SM, Lumens J, Naeije R, Newman J, Oudiz RJ, Provencher S, Torbicki A, Voelkel NF, Hassoun PM (2013) Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology. J Am Coll Cardiol 62:D22–D33

    Article  PubMed  Google Scholar 

  3. Sun LY, Zhao H, Kang Y, Shen XD, Cai ZY, Shen JY, He B, Yang CD (2014) Two-dimensional echocardiography in the assessment of long-term prognosis in patients with pulmonary arterial hypertension. PLoS One 9:e114443

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Yu CM, Sanderson JE, Chan S, Yeung L, Hung YT, Woo KS (1996) Right ventricular diastolic dysfunction in heart failure. Circulation 93:1509–1514

    Article  CAS  PubMed  Google Scholar 

  5. Rain S, Handoko ML, Trip P, Gan CT, Westerhof N, Stienen GJ, Paulus WJ, Ottenheijm CA, Marcus JT, Dorfmuller P et al (2013) Right ventricular diastolic impairment in patients with pulmonary arterial hypertension. Circulation 128:2016–2025

    Article  CAS  PubMed  Google Scholar 

  6. Pfeffer MA, Shah AM, Borlaug BA (2019) Heart failure with preserved ejection fraction in perspective. Circ Res 124:1598–1617

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Sanchez-Quintana D, Anderson RH, Ho SY (1996) Ventricular myoarchitecture in tetralogy of Fallot. Heart 76:280–286

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Ho SY, Nihoyannopoulos P (2006) Anatomy, echocardiography, and normal right ventricular dimensions. Heart 92(Suppl 1):i2–i13

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kocica MJ, Corno AF, Carreras-Costa F, Ballester-Rodes M, Moghbel MC, Cueva CN, Lackovic V, Kanjuh VI, Torrent-Guasp F (2006) The helical ventricular myocardial band: global, three-dimensional, functional architecture of the ventricular myocardium. Eur J Cardiothorac Surg 29(Suppl 1):S21–S40

    Article  PubMed  Google Scholar 

  10. Buckberg G, Hoffman JI (2014) Right ventricular architecture responsible for mechanical performance: unifying role of ventricular septum. J Thorac Cardiovasc Surg 148:3166–3171

    Article  PubMed  Google Scholar 

  11. Dell’Italia LJ (1991) The right ventricle: anatomy, physiology, and clinical importance. Curr Probl Cardiol 16:653–720

    Article  CAS  PubMed  Google Scholar 

  12. Kondo RP, Dederko DA, Teutsch C, Chrast J, Catalucci D, Chien KR, Giles WR (2006) Comparison of contraction and calcium handling between right and left ventricular myocytes from adult mouse heart: a role for repolarization waveform. J Physiol 571:131–146

    Article  CAS  PubMed  Google Scholar 

  13. Brooks WW, Bing OH, Blaustein AS, Allen PD (1987) Comparison of contractile state and myosin isozymes of rat right and left ventricular myocardium. J Mol Cell Cardiol 19:433–440

    Article  CAS  PubMed  Google Scholar 

  14. Brutsaert DL (2003) Cardiac endothelial-myocardial signaling: its role in cardiac growth, contractile performance, and rhythmicity. Physiol Rev 83:59–115

    Article  CAS  PubMed  Google Scholar 

  15. Winegrad S (1997) Endothelial cell regulation of contractility of the heart. Annu Rev Physiol 59:505–525

    Article  CAS  PubMed  Google Scholar 

  16. Sys SU, De Keulenaer GW, Brutsaert DL (1998) Physiopharmacological evaluation of myocardial performance: how to study modulation by cardiac endothelium and related humoral factors? Cardiovasc Res 39:136–147

    Article  CAS  PubMed  Google Scholar 

  17. Leucker TM, Jones SP (2014) Endothelial dysfunction as a nexus for endothelial cell-cardiomyocyte miscommunication. Front Physiol 5:328

    Article  PubMed  PubMed Central  Google Scholar 

  18. Biesiadecki BJ, Davis JP, Ziolo MT, Janssen PML (2014) Tri-modal regulation of cardiac muscle relaxation; intracellular calcium decline, thin filament deactivation, and cross-bridge cycling kinetics. Biophys Rev 6:273–289

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Hasenfuss G, Schillinger W, Lehnart SE, Preuss M, Pieske B, Maier LS, Prestle J, Minami K, Just H (1999) Relationship between Na+-Ca2+-exchanger protein levels and diastolic function of failing human myocardium. Circulation 99:641–648

    Article  CAS  PubMed  Google Scholar 

  20. Gordon AM, Homsher E, Regnier M (2000) Regulation of contraction in striated muscle. Physiol Rev 80:853–924

    Article  CAS  PubMed  Google Scholar 

  21. Robinson TF, Factor SM, Sonnenblick EH (1986) The heart as a suction pump. Sci Am 254:84–91

    Article  CAS  PubMed  Google Scholar 

  22. ter Keurs HE, Rijnsburger WH, van Heuningen R (1980) Restoring forces and relaxation of rat cardiac muscle. Eur Heart J Suppl A:67–80

  23. Niggli E, Lederer WJ (1991) Restoring forces in cardiac myocytes. Insight from relaxations induced by photolysis of caged ATP. Biophys J 59:1123–1135

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Helmes M, Trombitas K, Granzier H (1996) Titin develops restoring force in rat cardiac myocytes. Circ Res 79:619–626

    Article  CAS  PubMed  Google Scholar 

  25. Gillebert TC, Leite-Moreira AF, De Hert SG (1997) Relaxation-systolic pressure relation. A load-independent assessment of left ventricular contractility. Circulation 95:745–752

    Article  CAS  PubMed  Google Scholar 

  26. Chemla D, Coirault C, Hebert JL, Lecarpentier Y (2000) Mechanics of relaxation of the human heart. News Physiol Sci 15:78–83

    PubMed  Google Scholar 

  27. Udelson JE, Bacharach SL, Cannon RO 3rd, Bonow RO (1990) Minimum left ventricular pressure during beta-adrenergic stimulation in human subjects. Evidence for elastic recoil and diastolic “suction” in the normal heart. Circulation 82:1174–1182

    Article  CAS  PubMed  Google Scholar 

  28. Yellin EL, Nikolic S, Frater RW (1990) Left ventricular filling dynamics and diastolic function. Prog Cardiovasc Dis 32:247–271

    Article  CAS  PubMed  Google Scholar 

  29. Eichhorn EJ, Willard JE, Alvarez L, Kim AS, Glamann DB, Risser RC, Grayburn PA (1992) Are contraction and relaxation coupled in patients with and without congestive heart failure? Circulation 85:2132–2139

    Article  CAS  PubMed  Google Scholar 

  30. Garcia MIM, Santos A (2020) Understanding ventriculo-arterial coupling. Ann Transl Med 8(12). https://doi.org/10.21037/atm.2020.04.10

  31. Frenneaux M, Williams L (2007) Ventricular-arterial and ventricular-ventricular interactions and their relevance to diastolic filling. Prog Cardiovasc Dis 49:252–262

    Article  PubMed  Google Scholar 

  32. Vonk Noordegraaf A, Chin KM, Haddad F, Hassoun PM, Hemnes AR, Hopkins SR, Kawut SM, Langleben D, Lumens J, Naeije R (2019) Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: an update. Eur Respir J 53(1):1801900

    Article  PubMed  PubMed Central  Google Scholar 

  33. Tello K, Seeger W, Naeije R, Vanderpool R, Ghofrani HA, Richter M, Tedford RJ, Bogaard HJ (2021) Right heart failure in pulmonary hypertension: diagnosis and new perspectives on vascular and direct right ventricular treatment. Br J Pharmacol 178:90–107

    Article  CAS  PubMed  Google Scholar 

  34. Klotz S, Hay I, Dickstein ML, Yi GH, Wang J, Maurer MS, Kass DA, Burkhoff D (2006) Single-beat estimation of end-diastolic pressure-volume relationship: a novel method with potential for noninvasive application. Am J Physiol Heart Circ Physiol 291:H403–H4012

    Article  CAS  PubMed  Google Scholar 

  35. Trip P, Rain S, Handoko ML, van der Bruggen C, Bogaard HJ, Marcus JT, Boonstra A, Westerhof N, Vonk-Noordegraaf A, de Man FS (2015) Clinical relevance of right ventricular diastolic stiffness in pulmonary hypertension. Eur Respir J 45:1603–1612

    Article  PubMed  Google Scholar 

  36. Kelly CR, Rabbani LE (2013) Videos in clinical medicine. Pulmonary-artery catheterization N Engl J Med 369:e35

    PubMed  Google Scholar 

  37. Murch SD, La Gerche A, Roberts TJ, Prior DL, MacIsaac AI, Burns AT (2015) Abnormal right ventricular relaxation in pulmonary hypertension. Pulm Circ 5:370–375

    Article  PubMed  PubMed Central  Google Scholar 

  38. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713; quiz 786–8.

  39. Kasper J, Bolliger D, Skarvan K, Buser P, Filipovic M, Seeberger MD (2012) Additional cross-sectional transesophageal echocardiography views improve perioperative right heart assessment. Anesthesiology 117:726–734

    Article  PubMed  Google Scholar 

  40. Tan CO, Harley I (2014) Perioperative transesophageal echocardiographic assessment of the right heart and associated structures: a comprehensive update and technical report. J Cardiothorac Vasc Anesth 28:1100–1121

    Article  PubMed  Google Scholar 

  41. D’Andrea A, Vriz O, Carbone A, Ferrara F, Di Maio M, Cocchia R, Tagliamonte G, Acri E, Driussi C, Pezzullo E, Citro R, Cittadini A, Calabro R, Giovanna Russo M, Bossone E (2017) The impact of age and gender on right ventricular diastolic function among healthy adults. J Cardiol 70:387–395

    Article  PubMed  Google Scholar 

  42. Karhausen J, Dudaryk R, Phillips-Bute B, Rivera JD, de Lange F, Milano CA, Swaminathan M, Mackensen GB (2012) Three-dimensional transesophageal echocardiography for perioperative right ventricular assessment. Ann Thorac Surg 94:468–474

    Article  PubMed  Google Scholar 

  43. Kossaify A (2015) Echocardiographic assessment of the right ventricle, from the conventional approach to speckle tracking and three-dimensional imaging, and insights into the “right way” to explore the forgotten chamber. Clin Med Insights Cardiol 9:65–75

    Article  PubMed  PubMed Central  Google Scholar 

  44. Caudron J, Fares J, Bauer F, Dacher JN (2011) Evaluation of left ventricular diastolic function with cardiac MR imaging. Radiographics 31:239–259

    Article  PubMed  Google Scholar 

  45. Geva T (2014) Is MRI the preferred method for evaluating right ventricular size and function in patients with congenital heart disease?: MRI is the preferred method for evaluating right ventricular size and function in patients with congenital heart disease. Circ Cardiovasc Imaging 7:190–197

    Article  PubMed  PubMed Central  Google Scholar 

  46. Riggs TW (1993) Abnormal right ventricular filling in patients with dilated cardiomyopathy. Pediatr Cardiol 14:1–4

    Article  CAS  PubMed  Google Scholar 

  47. Fujimoto S, Parker KH, Gibson DG (1995) Right ventricular filling in dilated cardiomyopathy. Br Heart J 74:287–292

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Chakko S, de Marchena E, Kessler KM, Materson BJ, Myerburg RJ (1990) Right ventricular diastolic function in systemic hypertension. Am J Cardiol 65:1117–1120

    Article  CAS  PubMed  Google Scholar 

  49. Efthimiadis GK, Parharidis GE, Gemitzis KD, Nouskas IG, Karvounis HI, Styliadis IK, Louridas GE (1999) Doppler echocardiographic evaluation of right ventricular diastolic function in isolated valvular aortic stenosis. J Heart Valve Dis 8:261–269

    CAS  PubMed  Google Scholar 

  50. Dourvas IN, Parharidis GE, Efthimiadis GK, Karvounis HI, Gemitzis KD, Styliadis IH, Karoulas TN, Louridas GE (2004) Right ventricular diastolic function in patients with chronic aortic regurgitation. Am J Cardiol 93:115–117

    Article  PubMed  Google Scholar 

  51. Efthimiadis GK, Parharidis GE, Karvounis HI, Gemitzis KD, Styliadis IH, Louridas GE (2002) Doppler echocardiographic evaluation of right ventricular diastolic function in hypertrophic cardiomyopathy. Eur J Echocardiogr 3:143–148

    Article  CAS  PubMed  Google Scholar 

  52. Marcus JT, Gan CT, Zwanenburg JJ, Boonstra A, Allaart CP, Gotte MJ, Vonk-Noordegraaf A (2008) Interventricular mechanical asynchrony in pulmonary arterial hypertension: left-to-right delay in peak shortening is related to right ventricular overload and left ventricular underfilling. J Am Coll Cardiol 51:750–757

    Article  PubMed  Google Scholar 

  53. Vonk Noordegraaf A, Westerhof BE, Westerhof N (2017) The relationship between the right ventricle and its load in pulmonary hypertension. J Am Coll Cardiol 69:236–243

    Article  PubMed  Google Scholar 

  54. Hayabuchi Y, Ono A, Homma Y, Kagami S (2018) Analysis of right ventricular myocardial stiffness and relaxation components in children and adolescents with pulmonary arterial hypertension. J Am Heart Assoc 7(9):e008670

    Article  PubMed  PubMed Central  Google Scholar 

  55. Barbosa MM, Beleigoli AM, de Fatima DM, Freire CV, Ribeiro AL, Nunes MC (2011) Strain imaging in morbid obesity: insights into subclinical ventricular dysfunction. Clin Cardiol 34:288–293

    Article  PubMed  PubMed Central  Google Scholar 

  56. Florea VG, Florea ND, Sharma R, Coats AJ, Gibson DG, Hodson ME, Henein MY (2000) Right ventricular dysfunction in adult severe cystic fibrosis. Chest 118:1063–1068

    Article  CAS  PubMed  Google Scholar 

  57. Turhan S, Tulunay C, Ozduman Cin M, Gursoy A, Kilickap M, Dincer I, Candemir B, Gullu S, Erol C (2006) Effects of thyroxine therapy on right ventricular systolic and diastolic function in patients with subclinical hypothyroidism: a study by pulsed wave tissue Doppler imaging. J Clin Endocrinol Metab 91:3490–3493

    Article  CAS  PubMed  Google Scholar 

  58. Barros MV, Machado FS, Ribeiro AL, Da Costa Rocha MO (2002) Detection of early right ventricular dysfunction in Chagas’ disease using Doppler tissue imaging. J Am Soc Echocardiogr 15:1197–1201

    Article  PubMed  Google Scholar 

  59. Iskandar A, Mowakeaa S, Sardana M, Fitzgibbons TP, Tighe DA, Parker MW, Kakouros N, McManus D, Aurigemma GP (2018) The presbycardia phenotype: cardiac remodeling and valvular degeneration in nonagenarians. Echocardiography 35:1974–1981

    Article  PubMed  Google Scholar 

  60. Yilmaz M, Erol MK, Acikel M, Sevimli S, Alp N (2003) Pulsed Doppler tissue imaging can help to identify patients with right ventricular infarction. Heart Vessels 18:112–116

    Article  PubMed  Google Scholar 

  61. Denault AY, Couture P, Buithieu J, Haddad F, Carrier M, Babin D, Levesque S, Tardif JC (2006) Left and right ventricular diastolic dysfunction as predictors of difficult separation from cardiopulmonary bypass. Can J Anaesth 53:1020–1029

    Article  PubMed  Google Scholar 

  62. van Noord PT, Scohy TV, McGhie J, Bogers AJ (2010) Three-dimensional transesophageal echocardiography in Ebstein’s anomaly. Interact Cardiovasc Thorac Surg 10:836–837

    Article  PubMed  Google Scholar 

  63. Kemaloglu Oz T, Ozpamuk Karadeniz F, Akyuz S, Unal Dayi S, Esen Zencirci A, Atasoy I, Osken A, Eren M (2016) The advantages of live/real time three-dimensional transesophageal echocardiography during assessments of pulmonary stenosis. Int J Cardiovasc Imaging 32:573–582

    Article  PubMed  Google Scholar 

  64. Morris DA, Gailani M, Vaz Perez A, Blaschke F, Dietz R, Haverkamp W, Ozcelik C (2011) Right ventricular myocardial systolic and diastolic dysfunction in heart failure with normal left ventricular ejection fraction. J Am Soc Echocardiogr 24:886–897

    Article  PubMed  Google Scholar 

  65. Tadic M, Cuspidi C, Ivanovic B, Vukomanovic V, Djelic M, Celic V, Kocijancic V (2016) The impact of white-coat hypertension on cardiac mechanics. J Clin Hypertens (Greenwich) 18:617–622

    Article  Google Scholar 

  66. British Cardiac Society Guidelines and Medical Practice Committe, and approved by the British Thoracic Society and the British Society of Rheumatology (2001) Recommendations on the management of pulmonary hypertension in clinical practice. Heart 86(Suppl 1):I1–I13

    Google Scholar 

  67. Bossone E, Ferrara F, Grunig E (2015) Echocardiography in pulmonary hypertension. Curr Opin Cardiol 30:574–586

    Article  PubMed  Google Scholar 

  68. Mukerjee D, St George D, Knight C, Davar J, Wells AU, Du Bois RM, Black CM, Coghlan JG (2004) Echocardiography and pulmonary function as screening tests for pulmonary arterial hypertension in systemic sclerosis. Rheumatology (Oxford) 43:461–466

    Article  CAS  Google Scholar 

  69. Janda S, Shahidi N, Gin K, Swiston J (2011) Diagnostic accuracy of echocardiography for pulmonary hypertension: a systematic review and meta-analysis. Heart 97:612–622

    Article  PubMed  Google Scholar 

  70. Shiina Y, Funabashi N, Lee K, Daimon M, Sekine T, Kawakubo M, Takahashi M, Yajima R, Tanabe N, Kuriyama T, Komuro I (2009) Right atrium contractility and right ventricular diastolic function assessed by pulsed tissue Doppler imaging can predict brain natriuretic peptide in adults with acquired pulmonary hypertension. Int J Cardiol 135:53–59

    Article  PubMed  Google Scholar 

  71. Garcia MJ, Thomas JD, Klein AL (1998) New Doppler echocardiographic applications for the study of diastolic function. J Am Coll Cardiol 32:865–875

    Article  CAS  PubMed  Google Scholar 

  72. Gulati VK, Katz WE, Follansbee WP, Gorcsan J 3rd (1996) Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function. Am J Cardiol 77:979–984

    Article  CAS  PubMed  Google Scholar 

  73. Sohn DW, Chai IH, Lee DJ, Kim HC, Kim HS, Oh BH, Lee MM, Park YB, Choi YS, Seo JD, Lee YW (1997) Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 30:474–480

    Article  CAS  PubMed  Google Scholar 

  74. van Wolferen SA, Marcus JT, Boonstra A, Marques KM, Bronzwaer JG, Spreeuwenberg MD, Postmus PE, Vonk-Noordegraaf A (2007) Prognostic value of right ventricular mass, volume, and function in idiopathic pulmonary arterial hypertension. Eur Heart J 28:1250–1257

    Article  PubMed  Google Scholar 

  75. van de Veerdonk MC, Kind T, Marcus JT, Mauritz GJ, Heymans MW, Bogaard HJ, Boonstra A, Marques KM, Westerhof N, Vonk-Noordegraaf A (2011) Progressive right ventricular dysfunction in patients with pulmonary arterial hypertension responding to therapy. J Am Coll Cardiol 58:2511–2519

    Article  PubMed  Google Scholar 

  76. Sanz J, Garcia-Alvarez A, Fernandez-Friera L, Nair A, Mirelis JG, Sawit ST, Pinney S, Fuster V (2012) Right ventriculo-arterial coupling in pulmonary hypertension: a magnetic resonance study. Heart 98:238–243

    Article  PubMed  Google Scholar 

  77. Messroghli DR, Moon JC, Ferreira VM, Grosse-Wortmann L, He T, Kellman P, Mascherbauer J, Nezafat R, Salerno M, Schelbert EB, Taylor AJ, Thompson R, Ugander M, van Heeswijk RB, Friedrich MG (2017) Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson 19:75

    Article  PubMed  PubMed Central  Google Scholar 

  78. Doeblin P, Hashemi D, Tanacli R, Lapinskas T, Gebker R, Stehning C, Motzkus LA, Blum M, Tahirovic E, Dordevic A, Kraft R, Zamani SM, Pieske B, Edelmann F, Dungen HD, Kelle S (2019) CMR tissue characterization in patients with HFmrEF. J Clin Med 8(11):1877

  79. Chow PC, Liang XC, Cheung EW, Lam WW, Cheung YF (2008) New two-dimensional global longitudinal strain and strain rate imaging for assessment of systemic right ventricular function. Heart 94:855–859

    Article  PubMed  Google Scholar 

  80. Tello K, Wan J, Dalmer A, Vanderpool R, Ghofrani HA, Naeije R, Roller F, Mohajerani E, Seeger W, Herberg U, Sommer N, Gall H, Richter MJ (2019) Validation of the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio for the assessment of right ventricular-arterial coupling in severe pulmonary hypertension. Circ Cardiovasc Imaging 12:e009047

    Article  PubMed  PubMed Central  Google Scholar 

  81. Okumura K, Slorach C, Mroczek D, Dragulescu A, Mertens L, Redington AN, Friedberg MK (2014) Right ventricular diastolic performance in children with pulmonary arterial hypertension associated with congenital heart disease: correlation of echocardiographic parameters with invasive reference standards by high-fidelity micromanometer catheter. Circ Cardiovasc Imaging 7:491–501

    Article  PubMed  Google Scholar 

  82. Prins KW, Rose L, Archer SL, Pritzker M, Weir EK, Olson MD, Thenappan T (2019) Clinical determinants and prognostic implications of right ventricular dysfunction in pulmonary hypertension caused by chronic lung disease. J Am Heart Assoc 8:e011464

    Article  PubMed  PubMed Central  Google Scholar 

  83. Sagie A, Benjamin EJ, Galderisi M, Larson MG, Evans JC, Fuller DL, Lehman B, Levy D (1993) Echocardiographic assessment of left ventricular structure and diastolic filling in elderly subjects with borderline isolated systolic hypertension (the Framingham Heart Study). Am J Cardiol 72:662–665

    Article  CAS  PubMed  Google Scholar 

  84. van Wolferen SA, Marcus JT, Westerhof N, Spreeuwenberg MD, Marques KM, Bronzwaer JG, Henkens IR, Gan CT, Boonstra A, Postmus PE, Vonk-Noordegraaf A (2008) Right coronary artery flow impairment in patients with pulmonary hypertension. Eur Heart J 29:120–127

    Article  PubMed  Google Scholar 

  85. Ren X, Johns RA, Gao WD (2019) EXPRESS: eight heart in pulmonary hypertension: from adaptation to failure. Pulm Circ 9(3):2045894019845611

    Article  PubMed Central  CAS  Google Scholar 

  86. Frangogiannis NG (2019) The extracellular matrix in ischemic and nonischemic heart failure. Circ Res 125:117–146

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Kasner M, Westermann D, Lopez B, Gaub R, Escher F, Kuhl U, Schultheiss HP, Tschope C (2011) Diastolic tissue Doppler indexes correlate with the degree of collagen expression and cross-linking in heart failure and normal ejection fraction. J Am Coll Cardiol 57:977–985

    Article  CAS  PubMed  Google Scholar 

  88. LeWinter MM, Granzier HL (2014) Cardiac titin and heart disease. J Cardiovasc Pharmacol 63:207–212

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Reddy S, Hu DQ, Zhao M, Blay E Jr, Sandeep N, Ong SG, Jung G, Kooiker KB, Coronado M, Fajardo G, Bernstein D (2017) miR-21 is associated with fibrosis and right ventricular failure. JCI Insight 2(9):e91625

    Article  PubMed Central  Google Scholar 

  90. Poindron V, Chatelus E, Canuet M, Gottenberg JE, Arnaud L, Gangi A, Gavand PE, Guffroy A, Korganow AS, Germain P, Sibilia J, El Ghannudi S, Martin T (2020) T1 mapping cardiac magnetic resonance imaging frequently detects subclinical diffuse myocardial fibrosis in systemic sclerosis patients. Semin Arthritis Rheum 50:128–134

    Article  PubMed  Google Scholar 

  91. Borgdorff MA, Bartelds B, Dickinson MG, Steendijk P, de Vroomen M, Berger RM (2013) Distinct loading conditions reveal various patterns of right ventricular adaptation. Am J Physiol Heart Circ Physiol 305:H354–H364

    Article  CAS  PubMed  Google Scholar 

  92. Fowler ED, Benoist D, Drinkhill MJ, Stones R, Helmes M, Wust RC, Stienen GJ, Steele DS, White E (2015) Decreased creatine kinase is linked to diastolic dysfunction in rats with right heart failure induced by pulmonary artery hypertension. J Mol Cell Cardiol 86:1–8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Chung CS, Hutchinson KR, Methawasin M, Saripalli C, Smith JE 3rd, Hidalgo CG, Luo X, Labeit S, Guo C, Granzier HL (2013) Shortening of the elastic tandem immunoglobulin segment of titin leads to diastolic dysfunction. Circulation 128:19–28

    Article  CAS  PubMed  Google Scholar 

  94. Kruger M, Kotter S, Grutzner A, Lang P, Andresen C, Redfield MM, Butt E, dos Remedios CG, Linke WA (2009) Protein kinase G modulates human myocardial passive stiffness by phosphorylation of the titin springs. Circ Res 104:87–94

    Article  PubMed  CAS  Google Scholar 

  95. Zile MR, Baicu CF, Ikonomidis JS, Stroud RE, Nietert PJ, Bradshaw AD, Slater R, Palmer BM, Van Buren P, Meyer M, Redfield MM, Bull DA, Granzier HL, LeWinter MM (2015) Myocardial stiffness in patients with heart failure and a preserved ejection fraction: contributions of collagen and titin. Circulation 131:1247–1259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Kovacs A, Alogna A, Post H, Hamdani N (2016) Is enhancing cGMP-PKG signalling a promising therapeutic target for heart failure with preserved ejection fraction? Neth Heart J 24:268–274

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  97. Glantz SA, Misbach GA, Moores WY, Mathey DG, Lekven J, Stowe DF, Parmley WW, Tyberg JV (1978) The pericardium substantially affects the left ventricular diastolic pressure-volume relationship in the dog. Circ Res 42:433–441

    Article  CAS  PubMed  Google Scholar 

  98. Saleh S, Liakopoulos OJ, Buckberg GD (2006) The septal motor of biventricular function. Eur J Cardiothorac Surg 29(Suppl 1):S126–S138

    Article  PubMed  Google Scholar 

  99. Naeije R, Badagliacca R (2017) The overloaded right heart and ventricular interdependence. Cardiovasc Res 113:1474–1485

    Article  CAS  PubMed  Google Scholar 

  100. Leite-Moreira AF, Correia-Pinto J, Gillebert TC (1999) Afterload induced changes in myocardial relaxation: a mechanism for diastolic dysfunction. Cardiovasc Res 43:344–353

    Article  CAS  PubMed  Google Scholar 

  101. Garcia-Alvarez A, Garcia-Lunar I, Pereda D, Fernandez-Jimenez R, Sanchez-Gonzalez J, Mirelis JG, Nuno-Ayala M, Sanchez-Quintana D, Fernandez-Friera L, Garcia-Ruiz JM, Pizarro G, Aguero J, Campelos P, Castella M, Sabate M, Fuster V, Sanz J, Ibanez B (2015) Association of myocardial T1-mapping CMR with hemodynamics and RV performance in pulmonary hypertension. JACC Cardiovasc Imaging 8:76–82

    Article  PubMed  Google Scholar 

  102. Gan CT, Holverda S, Marcus JT, Paulus WJ, Marques KM, Bronzwaer JG, Twisk JW, Boonstra A, Postmus PE, Vonk-Noordegraaf A (2007) Right ventricular diastolic dysfunction and the acute effects of sildenafil in pulmonary hypertension patients. Chest 132:11–17

    Article  CAS  PubMed  Google Scholar 

  103. Zile MR, Baicu CF, Gaasch WH (2004) Diastolic heart failure–abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med 350:1953–1959

    Article  CAS  PubMed  Google Scholar 

  104. Gaasch WH, Zile MR (2004) Left ventricular diastolic dysfunction and diastolic heart failure. Annu Rev Med 55:373–394

    Article  CAS  PubMed  Google Scholar 

  105. Bursi F, Weston SA, Redfield MM, Jacobsen SJ, Pakhomov S, Nkomo VT, Meverden RA, Roger VL (2006) Systolic and diastolic heart failure in the community. JAMA 296:2209–2216

    Article  CAS  PubMed  Google Scholar 

  106. Sharma K, Kass DA (2014) Heart failure with preserved ejection fraction: mechanisms, clinical features, and therapies. Circ Res 115:79–96

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  107. Lam CS, Roger VL, Rodeheffer RJ, Borlaug BA, Enders FT, Redfield MM (2009) Pulmonary hypertension in heart failure with preserved ejection fraction: a community-based study. J Am Coll Cardiol 53:1119–1126

    Article  PubMed  PubMed Central  Google Scholar 

  108. Burke MA, Katz DH, Beussink L, Selvaraj S, Gupta DK, Fox J, Chakrabarti S, Sauer AJ, Rich JD, Freed BH, Shah SJ (2014) Prognostic importance of pathophysiologic markers in patients with heart failure and preserved ejection fraction. Circ Heart Fail 7:288–299

    Article  CAS  PubMed  Google Scholar 

  109. Puwanant S, Priester TC, Mookadam F, Bruce CJ, Redfield MM, Chandrasekaran K (2009) Right ventricular function in patients with preserved and reduced ejection fraction heart failure. Eur J Echocardiogr 10:733–737

    Article  PubMed  Google Scholar 

  110. Testani JM, Khera AV, St John Sutton MG, Keane MG, Wiegers SE, Shannon RP, Kirkpatrick JN (2010) Effect of right ventricular function and venous congestion on cardiorenal interactions during the treatment of decompensated heart failure. Am J Cardiol 105:511–516

    Article  PubMed  PubMed Central  Google Scholar 

  111. Akazawa Y, Fujioka T, Kuhn A, Hui W, Slorach C, Roehlig C, Mertens L, Vogt M, Friedberg MK (2019) Right ventricular diastolic function and right atrial function and their relation with exercise capacity in Ebstein anomaly. Can J Cardiol 35:1824–1833

    Article  PubMed  Google Scholar 

  112. Gilboa SM, Devine OJ, Kucik JE, Oster ME, Riehle-Colarusso T, Nembhard WN, Xu P, Correa A, Jenkins K, Marelli AJ (2016) Congenital heart defects in the United States: estimating the magnitude of the affected population in 2010. Circulation 134:101–109

    Article  PubMed  PubMed Central  Google Scholar 

  113. Frigiola A, Hughes M, Turner M, Taylor A, Marek J, Giardini A, Hsia TY, Bull K (2013) Physiological and phenotypic characteristics of late survivors of tetralogy of fallot repair who are free from pulmonary valve replacement. Circulation 128:1861–1868

    Article  PubMed  Google Scholar 

  114. Geva T (2013) Indications for pulmonary valve replacement in repaired tetralogy of fallot: the quest continues. Circulation 128:1855–1857

    Article  PubMed  PubMed Central  Google Scholar 

  115. Afilalo J, Lauck S, Kim DH, Lefevre T, Piazza N, Lachapelle K, Martucci G, Lamy A, Labinaz M, Peterson MD et al (2017) Frailty in older adults undergoing aortic valve replacement: The FRAILTY-AVR Study. J Am Coll Cardiol 70:689–700

    Article  PubMed  Google Scholar 

  116. Piankova P, Afilalo J (2020) Prevalence and prognostic implications of frailty in transcatheter aortic valve replacement. Cardiol Clin 38:75–87

    Article  PubMed  Google Scholar 

  117. Cicala S, Galderisi M, Caso P, Petrocelli A, D’Errico A, de Divitiis O, Calabro R (2002) Right ventricular diastolic dysfunction in arterial systemic hypertension: analysis by pulsed tissue Doppler. Eur J Echocardiogr 3:135–142

    Article  CAS  PubMed  Google Scholar 

  118. Abdeltawab A, Eweda I, Mostafa AE, Demian P, Awaad O (2018) Relation of RV function to presence of degree of systemic hypertension. J Cardiovasc Dis Diagn 6(1). https://doi.org/10.4172/2329-9517.1000306

  119. Dernellis J (2001) Right atrial function in hypertensive patients: effects of antihypertensive therapy. J Hum Hypertens 15:463–470

    Article  CAS  PubMed  Google Scholar 

  120. Chu JW, Crapo LM (2001) The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab 86:4591–4599

    Article  CAS  PubMed  Google Scholar 

  121. Kosar F, Sahin I, Turan N, Topal E, Aksoy Y, Taskapan C (2005) Evaluation of right and left ventricular function using pulsed-wave tissue Doppler echocardiography in patients with subclinical hypothyroidism. J Endocrinol Invest 28:704–710

    Article  CAS  PubMed  Google Scholar 

  122. Wong CY, O’Moore-Sullivan T, Leano R, Hukins C, Jenkins C, Marwick TH (2006) Association of subclinical right ventricular dysfunction with obesity. J Am Coll Cardiol 47:611–616

    Article  PubMed  Google Scholar 

  123. Sokmen A, Sokmen G, Acar G, Akcay A, Koroglu S, Koleoglu M, Yalcintas S, Aydin MN (2013) The impact of isolated obesity on right ventricular function in young adults. Arq Bras Cardiol 101:160–168

    PubMed  PubMed Central  Google Scholar 

  124. Ionescu AA, Ionescu AA, Payne N, Obieta-Fresnedo I, Fraser AG, Shale DJ (2001) Subclinical right ventricular dysfunction in cystic fibrosis. A study using tissue Doppler echocardiography. Am J Respir Crit Care Med 163:1212–1218

    Article  CAS  PubMed  Google Scholar 

  125. Labombarda F, Saloux E, Brouard J, Bergot E, Milliez P (2016) Heart involvement in cystic fibrosis: a specific cystic fibrosis-related myocardial changes? Respir Med 118:31–38

    Article  PubMed  Google Scholar 

  126. Megalla S, Holtzman D, Aronow WS, Nazari R, Korenfeld S, Schwarcz A, Goldberg Y, Spevack DM (2011) Predictors of cardiac hepatopathy in patients with right heart failure. Med Sci Monit 17:CR537–41.

  127. Sumin AN, Korok EV, Sergeeva TJ (2021) Preexisting right ventricular diastolic dysfunction and postoperative cardiac complications in patients undergoing nonemergency coronary artery bypass surgery. J Cardiothorac Vasc Anesth 35:799–806

    Article  PubMed  Google Scholar 

  128. Gorter TM, van Veldhuisen DJ, Bauersachs J, Borlaug BA, Celutkiene J, Coats AJS, Crespo-Leiro MG, Guazzi M, Harjola VP, Heymans S et al (2018) Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 20:16–37

    Article  PubMed  Google Scholar 

  129. Galie N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M et al (2016) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37:67–119

    Article  PubMed  Google Scholar 

  130. Vachiery JL, Adir Y, Barbera JA, Champion H, Coghlan JG, Cottin V, De Marco T, Galie N, Ghio S, Gibbs JS, Martinez F, Semigran M, Simonneau G, Wells A, Seeger W (2013) Pulmonary hypertension due to left heart diseases. J Am Coll Cardiol 62:D100–D108

    Article  PubMed  Google Scholar 

  131. Shah AM, Shah SJ, Anand IS, Sweitzer NK, O’Meara E, Heitner JF, Sopko G, Li G, Assmann SF, McKinlay SM, Pitt B, Pfeffer MA, Solomon SD, Investigators TOPCAT (2014) Cardiac structure and function in heart failure with preserved ejection fraction: baseline findings from the echocardiographic study of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial. Circ Heart Fail 7:104–115

    Article  CAS  PubMed  Google Scholar 

  132. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL et al (2013) 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 62:e147–e239

    Article  PubMed  Google Scholar 

  133. Layland J, Solaro RJ, Shah AM (2005) Regulation of cardiac contractile function by troponin I phosphorylation. Cardiovasc Res 66:12–21

    Article  CAS  PubMed  Google Scholar 

  134. Papadaki M, Vikhorev PG, Marston SB, Messer AE (2015) Uncoupling of myofilament Ca2+ sensitivity from troponin I phosphorylation by mutations can be reversed by epigallocatechin-3-gallate. Cardiovasc Res 108:99–110

    Article  CAS  PubMed  Google Scholar 

  135. Marston S (2019) Small molecule studies: the fourth wave of muscle research. J Muscle Res Cell Motil 40:69–76

    Article  PubMed  PubMed Central  Google Scholar 

  136. Ren X, Schmidt W, Huang Y, Lu H, Liu W, Bu W, Eckenhoff R, Cammarato A, Gao WD (2018) Fropofol decreases force development in cardiac muscle. FASEB J 32:4203–4213

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  137. Sweeney M, Corden B, Cook SA (2020) Targeting cardiac fibrosis in heart failure with preserved ejection fraction: mirage or miracle? EMBO Mol Med 12:e10865

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  138. Lewis GA, Schelbert EB, Naish JH, Bedson E, Dodd S, Eccleson H, Clayton D, Jimenez BD, McDonagh T, Williams SG, Cooper A, Cunnington C, Ahmed FZ, Viswesvaraiah R, Russell S, Neubauer S, Williamson PR, Miller CA (2019) Pirfenidone in heart failure with preserved ejection fraction-rationale and design of the PIROUETTE Trial. Cardiovasc Drugs Ther 33:461–470

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  139. Yu L, Ruifrok WP, Meissner M, Bos EM, van Goor H, Sanjabi B, van der Harst P, Pitt B, Goldstein IJ, Koerts JA, van Veldhuisen DJ, Bank RA, van Gilst WH, Sillje HH, de Boer RA (2013) Genetic and pharmacological inhibition of galectin-3 prevents cardiac remodeling by interfering with myocardial fibrogenesis. Circ Heart Fail 6:107–117

    Article  CAS  PubMed  Google Scholar 

  140. Verma S, Garg A, Yan AT, Gupta AK, Al-Omran M, Sabongui A, Teoh H, Mazer CD, Connelly KA (2016) Effect of empagliflozin on left ventricular mass and diastolic function in individuals with diabetes: an important clue to the EMPA-REG OUTCOME Trial? Diabetes Care 39:e212–e213

    Article  PubMed  Google Scholar 

  141. Scheffer M, Driessen-Waaijer A, Hamdani N, Landzaat JWD, Jonkman NH, Paulus WJ, van Heerebeek L (2020) Stratified treatment of heart failure with preserved ejection fraction: rationale and design of the STADIA-HFpEF trial. ESC Heart Fail 7:4478–4487

    Article  PubMed Central  Google Scholar 

  142. Diamant M, Lamb HJ, Groeneveld Y, Endert EL, Smit JW, Bax JJ, Romijn JA, de Roos A, Radder JK (2003) Diastolic dysfunction is associated with altered myocardial metabolism in asymptomatic normotensive patients with well-controlled type 2 diabetes mellitus. J Am Coll Cardiol 42:328–335

    Article  CAS  PubMed  Google Scholar 

  143. Slinker BK, Ditchey RV, Bell SP, LeWinter MM (1987) Right heart pressure does not equal pericardial pressure in the potassium chloride-arrested canine heart in situ. Circulation 76:357–362

    Article  CAS  PubMed  Google Scholar 

  144. Borlaug BA, Carter RE, Melenovsky V, DeSimone CV, Gaba P, Killu A, Naksuk N, Lerman L, Asirvatham SJ (2017) Percutaneous pericardial resection: a novel potential treatment for heart failure with preserved ejection fraction. Circ Heart Fail 10:e003612

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Youn-Hoa Jung, Giancarlo Suffredini, Jeffery M. Dodd-o & Wei Dong Gao

  2. Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China

    Xianfeng Ren

Authors
  1. Youn-Hoa Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xianfeng Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giancarlo Suffredini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jeffery M. Dodd-o
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wei Dong Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

YJ, XR, and WDG were involved in initial conception and design, literature search and review, and finalization of scope of the manuscript; YJ and XR contributed equally; YJ, XR, GC, JMD, and WDG were involved in writing the manuscript; GC, JMD, and WDG edited and finalized the manuscript.

Corresponding author

Correspondence to Wei Dong Gao.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jung, YH., Ren, X., Suffredini, G. et al. Right ventricular diastolic dysfunction and failure: a review. Heart Fail Rev 27, 1077–1090 (2022). https://doi.org/10.1007/s10741-021-10123-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10741-021-10123-8

Keywords

Search

Navigation