The prognostic role of right ventricular function in left ventricular disease in the setting of cardiac resynchronization therapy

Abstract

Cardiac resynchronization therapy (CRT) offers a new therapeutic approach for treating patients with ventricular dyssynchrony and moderate-to-severe heart failure (HF). The impact of right ventricular dysfunction on global cardiac function remains imperfectly understood despite increasing research on right ventricular function as it pertains to long-term outcomes in HF. In this article, we aim to review the prognostic role of right ventricular function in the setting of CRT. Right ventricular dysfunction has emerged as a strong prognostic predictor of poor clinical outcomes in HF patients with CRT. The presence of right ventricular dysfunction at baseline is associated with poor prognosis and CRT response. Preliminary data indicate that CRT may have a positive influence on right ventricular remodeling and function. CRT guidelines continue to be optimized on the basis of emerging data. The prognostic role of right ventricular dyssynchrony and right ventricular response to CRT will further contribute to the understanding of this topic and the identification of HF populations that will benefit from this therapy. As the impact of right ventricular function on global cardiopulmonary function remains imperfectly understood, ongoing research on right ventricular function in HF patients with CRT and its implication for long-term outcome is required. It is, however, clear that right ventricular function is a prognostic marker of response to CRT and adverse long-term outcome. Conversely, recent data indicate that CRT may in turn influence right ventricular remodeling and function.