Advanced Molecular, Metabolic, and Imaging Approaches to Characterizing Right Ventricular Failure


  • In pulmonary hypertension, chronic pressure overload can progress from adaptive right ventricular (RV) hypertrophy to maladaptive remodeling, characterized by RV dilation, fibrosis, stiffness, and RV–pulmonary artery (PA) uncoupling.
  • Therapeutic strategies are increasingly shifting toward RV–targeted approaches, such as modulation of inflammation, fibrosis, metabolism, and RV–PA coupling, highlighting the need for RV–specific endpoints in clinical trials.
  • Future progress in RV failure will depend on integrated precision phenotyping that combines advanced imaging, circulating biomarkers, multi-omics approaches, artificial intelligence, and machine learning to enable earlier detection and personalized therapy.