{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:09:31Z","timestamp":1780304971722,"version":"3.54.0"},"reference-count":87,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The right ventricle (RV) is a primary determinant of outcomes in cardiac critical care. RV dysfunction independently predicts morbidity and mortality in conditions such as acute coronary syndromes, pulmonary embolism, and cardiogenic shock. This review synthesizes RV evaluation and management by integrating physiologic principles with bedside diagnostic and therapeutic strategies. The RV is exceptionally sensitive to acute afterload increases due to its adaptation to low-pressure pulmonary circulation. Evaluation utilizes a multimodal approach combining echocardiography, invasive hemodynamics, and specifically the pulmonary artery pulsatility index and central venous pressure\/pulmonary capillary wedge pressure (CVP\/PCWP) ratio and biomarkers. Management focuses on three pillars: individualized preload optimization, afterload reduction via selective pulmonary vasodilators, and contractility augmentation with inotropes. For refractory cases, mechanical circulatory support options like Impella RP, ProtekDuo, and VA-ECMO provide critical bridges to recovery or transplantation.<\/jats:p>","DOI":"10.3390\/medicina62061070","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T08:09:16Z","timestamp":1780301356000},"page":"1070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Right Ventricle in Cardiac Critical Care: Pathophysiology, Evaluation and Management"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5008-114X","authenticated-orcid":false,"given":"Aristi","family":"Boulmpou","sequence":"first","affiliation":[{"name":"Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4889-677X","authenticated-orcid":false,"given":"Ioannis","family":"Alevroudis","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8328-5942","authenticated-orcid":false,"given":"Efstratios","family":"Karagiannidis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, AHEPA University Hospital, 546 36 Thessaloniki, Greece"},{"name":"Second Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7804-8352","authenticated-orcid":false,"given":"Sophia-Anastasia","family":"Mouratoglou","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-5297","authenticated-orcid":false,"given":"Athina","family":"Nasoufidou","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7158-4950","authenticated-orcid":false,"given":"Nikolaos","family":"Fragakis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9643-9066","authenticated-orcid":false,"given":"Christodoulos","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-9170","authenticated-orcid":false,"given":"Vassilios","family":"Vassilikos","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref_1","first-page":"18","article-title":"The forgotten chamber: The importance of the right ventricle","volume":"35","author":"Rigolin","year":"1995","journal-title":"Catheter. Cardiovasc. Diagn."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.jacc.2018.12.076","article-title":"Anatomy, Function, and Dysfunction of the Right Ventricle: JACC State-of-the-Art Review","volume":"73","author":"Sanz","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Torre, D.E., and Pirri, C. (2025). Right Heart Failure in Critical and Chronic Care: Current Concepts, Challenges and Mechanical Support Strategies. Med. Sci., 13.","DOI":"10.3390\/medsci13040210"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.31083\/j.rcm2204131","article-title":"Right ventricular myocardial infarction: Pathophysiology, clinical implications and management","volume":"22","author":"Femia","year":"2021","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.bjae.2019.02.004","article-title":"Clinical presentation and management of right ventricular dysfunction","volume":"19","author":"Murphy","year":"2019","journal-title":"BJA Educ."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1007\/s11897-023-00600-6","article-title":"Assessment of Right Ventricular Function-a State of the Art","volume":"20","author":"Hameed","year":"2023","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Nonaka, H., R\u00e4tsep, I., Obonyo, N.G., Suen, J.Y., Fraser, J.F., and Chan, J. (2024). Current trends and latest developments in echocardiographic assessment of right ventricular function: Load dependency perspective. Front. Cardiovasc. Med., 11.","DOI":"10.3389\/fcvm.2024.1365798"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"i2","DOI":"10.1136\/hrt.2005.077875","article-title":"Anatomy, echocardiography, and normal right ventricular dimensions","volume":"92","author":"Ho","year":"2006","journal-title":"Heart"},{"key":"ref_9","first-page":"100049","article-title":"An Anatomical Review of the Right Ventricle","volume":"17","author":"Wang","year":"2019","journal-title":"Transl. Res. Anat."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1161\/01.CIR.34.3.377","article-title":"The Gradient in Pressure Across the Pulmonary Vascular Bed During Diastole","volume":"34","author":"Kaltman","year":"1966","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1093\/cvr\/cvx160","article-title":"The overloaded right heart and ventricular interdependence","volume":"113","author":"Naeije","year":"2017","journal-title":"Cardiovasc. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.jacc.2016.10.047","article-title":"The Relationship Between the Right Ventricle and its Load in Pulmonary Hypertension","volume":"69","author":"Westerhof","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","first-page":"e012611","article-title":"Pulmonary Circulation in Advanced Heart Failure and Cardiogenic Shock: State-of-the-Art Review","volume":"18","author":"Hungerford","year":"2025","journal-title":"Circ. Heart Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e005512","DOI":"10.1161\/CIRCHEARTFAILURE.118.005512","article-title":"Reserve of Right Ventricular-Arterial Coupling in the Setting of Chronic Overload","volume":"12","author":"Tello","year":"2019","journal-title":"Circ. Heart Fail."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9993060","DOI":"10.1155\/2021\/9993060","article-title":"Exploring Functional Differences between the Right and Left Ventricles to Better Understand Right Ventricular Dysfunction","volume":"2021","author":"Talamilla","year":"2021","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/S0033-0620(98)80051-0","article-title":"Right heart ischemia: Pathophysiology, natural history, and clinical management","volume":"40","author":"Goldstein","year":"1998","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1801900","DOI":"10.1183\/13993003.01900-2018","article-title":"Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: An update","volume":"53","author":"Chin","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8217105","DOI":"10.1155\/2017\/8217105","article-title":"Acute Right Ventricular Dysfunction in Intensive Care Unit","volume":"2017","author":"Grignola","year":"2017","journal-title":"BioMed Res. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"37460","DOI":"10.31083\/RCM37460","article-title":"Metabolic Alterations Associated With Right Ventricular Dysfunction in Pulmonary Arterial Hypertension: The Modulatory Effects and Improvement Mechanisms of Exercise","volume":"26","author":"Chen","year":"2025","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1007\/s00109-010-0679-1","article-title":"Mitochondrial metabolic adaptation in right ventricular hypertrophy and failure","volume":"88","author":"Piao","year":"2010","journal-title":"J. Mol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1901647","DOI":"10.1183\/13993003.01647-2019","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)","volume":"54","author":"Konstantinides","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wanner, P.M., and Filipovic, M. (2020). The Right Ventricle-You May Forget it, but It Will Not Forget You. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020432"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.15420\/cfr.2025.02","article-title":"Addressing Endothelial Dysfunction in Heart Failure: The Role of Endothelial Progenitor Cells and New Treatment Horizons","volume":"11","author":"Carulli","year":"2025","journal-title":"Card. Fail. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1152\/physrev.00041.2010","article-title":"Hypoxic pulmonary vasoconstriction","volume":"92","author":"Sylvester","year":"2012","journal-title":"Physiol. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"111434","DOI":"10.5492\/wjccm.v14.i4.111434","article-title":"Pathophysiology and management of right ventricular failure in critically ill patients: A narrative review","volume":"14","author":"Kermanian","year":"2025","journal-title":"World J. Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.chest.2020.09.274","article-title":"Right Ventricular Dysfunction in Early Sepsis and Septic Shock","volume":"159","author":"Lanspa","year":"2021","journal-title":"Chest"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s00408-025-00862-y","article-title":"Acute Right Ventricular Failure in the Medical ICU","volume":"203","author":"Dodi","year":"2025","journal-title":"Lung"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"272","DOI":"10.31083\/j.rcm2508272","article-title":"Load Dependency of Ventricular Pump Function: Impact on the Non-Invasive Evaluation of the Severity and the Prognostic Relevance of Myocardial Dysfunction","volume":"25","author":"Dandel","year":"2024","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.ijcard.2016.07.014","article-title":"Echocardiographic assessment of the right ventricle: Impact of the distinctly load dependency of its size, geometry and performance","volume":"221","author":"Dandel","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1111\/echo.13651","article-title":"Echocardiographic assessment of the right ventricle in the current era: Application in clinical practice","volume":"34","author":"Venkatachalam","year":"2017","journal-title":"Echocardiography"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Moln\u00e1r, A., S\u00e1nta, A., and Merkely, B. (2023). Echocardiography Imaging of the Right Ventricle: Focus on Three-Dimensional Echocardiography. Diagnostics, 13.","DOI":"10.3390\/diagnostics13152470"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.amjcard.2007.09.115","article-title":"Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study)","volume":"101","author":"Anavekar","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.echo.2020.01.019","article-title":"Subjective Evaluation of Right Ventricular Function with Transesophageal Echocardiography","volume":"33","author":"Silverton","year":"2020","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Torre, D.E., and Pirri, C. (2025). Point-of-Care Transesophageal Echocardiography in Emergency and Intensive Care: An Evolving Imaging Modality. Biomedicines, 13.","DOI":"10.3390\/biomedicines13112680"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1093\/ehjci\/jeac022","article-title":"Right ventricular longitudinal strain in the clinical routine: A state-of-the-art review","volume":"23","author":"Muraru","year":"2022","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Tadic, M., Nita, N., Schneider, L., Kersten, J., Buckert, D., Gonska, B., Scharnbeck, D., Reichart, C., Belyavskiy, E., and Cuspidi, C. (2021). The Predictive Value of Right Ventricular Longitudinal Strain in Pulmonary Hypertension, Heart Failure, and Valvular Diseases. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.698158"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1097\/HCO.0b013e32832cf8f6","article-title":"3D echocardiography: Evaluation of the right ventricle","volume":"24","author":"Shiota","year":"2009","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e001780","DOI":"10.1136\/tsaco-2025-001780","article-title":"Invasive and non-invasive monitoring in the ICU","volume":"10","author":"McEachron","year":"2025","journal-title":"Trauma. Surg. Acute Care Open"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1111\/anae.16633","article-title":"Measurement and interpretation of central venous pressure: A narrative review","volume":"80","author":"Fujino","year":"2025","journal-title":"Anaesthesia"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/ejhf.1679","article-title":"Pulmonary artery pulsatility index: Physiological basis and clinical application","volume":"22","author":"Lim","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1532-429X-10-40","article-title":"Evaluating the systemic right ventricle by CMR: The importance of consistent and reproducible delineation of the cavity","volume":"10","author":"Winter","year":"2008","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1532-429X-15-23","article-title":"Assessment of the right ventricle with cardiovascular magnetic resonance at 7 Tesla","volume":"15","author":"Tkachenko","year":"2013","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s00330-011-2345-6","article-title":"Left and right ventricle assessment with Cardiac CT: Validation study vs. Cardiac MR","volume":"22","author":"Maffei","year":"2012","journal-title":"Eur. Radiol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Viduljevi\u0107, M., Polovina, M., Geavlete, O., Adamo, M., Had\u017eibegovi\u0107, A., A\u0161anin, M., Stankovi\u0107, S., Ben Gal, T., Abdelwahab, M.A., and Abdelhamid, M. (2025). The Right Approach: Power of Biomarkers in the Assessment and Management of Right Ventricular Dysfunction. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26189064"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Stiermaier, T., Backhaus, S.J., Matz, J., Koschalka, A., Kowallick, J., de Waha-Thiele, S., Gutberlet, M., Hasenfu\u00df, G., Thiele, H., and Eitel, I. (2020). Frequency and prognostic impact of right ventricular involvement in acute myocardial infarction. Heart, ahead of print.","DOI":"10.1093\/ehjci\/ehaa946.1609"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1016\/j.jacc.2023.09.839","article-title":"Right Ventricular Myocardial Infarction-A Tale of Two Ventricles: JACC Focus Seminar 1\/5","volume":"83","author":"Goldstein","year":"2024","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1136\/pgmj.2010.103887","article-title":"Right ventricular myocardial infarction: Pathophysiology, diagnosis, and management","volume":"86","author":"Kakouros","year":"2010","journal-title":"Postgrad. Med. J."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Patel, M., Maheta, D., Agrawal, S., Bhatia, H., Frishman, W.H., and Aronow, W.S. (2025). Right Ventricular Myocardial Infarction: Pathophysiology, Diagnosis, and Therapeutic Approaches. Cardiol. Rev., ahead of print.","DOI":"10.1097\/CRD.0000000000000859"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"134","DOI":"10.15420\/aer.2017.24.1","article-title":"Ventricular Arrhythmia after Acute Myocardial Infarction: \u2018The Perfect Storm\u2019","volume":"6","author":"Davies","year":"2017","journal-title":"Arrhythm. Electrophysiol. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13244-019-0695-9","article-title":"Pathophysiology of right ventricular failure in acute pulmonary embolism and chronic thromboembolic pulmonary hypertension: A pictorial essay for the interventional radiologist","volume":"10","author":"Bryce","year":"2019","journal-title":"Insights Imaging"},{"key":"ref_51","first-page":"e70561","article-title":"Pulmonary Embolism and Right Ventricular Dysfunction: Mechanism and Management","volume":"16","author":"Ajah","year":"2024","journal-title":"Cureus"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s00380-021-01924-w","article-title":"PESI score for predicting clinical outcomes in PE patients with right ventricular involvement","volume":"37","author":"Natanzon","year":"2022","journal-title":"Heart Vessel."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.jcin.2023.02.004","article-title":"Prevalence and Predictors of Cardiogenic Shock in Intermediate-Risk Pulmonary Embolism: Insights From the FLASH Registry","volume":"16","author":"Bangalore","year":"2023","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"102153","DOI":"10.1016\/j.eclinm.2023.102153","article-title":"Prevalence of long-term right ventricular dysfunction after acute pulmonary embolism: A systematic review and meta-analysis","volume":"62","author":"Wang","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1093\/eurheartj\/ehaf215","article-title":"Acute right ventricular failure: Pathophysiology, aetiology, assessment, and management","volume":"46","author":"Giannakoulas","year":"2025","journal-title":"Eur. Heart J."},{"key":"ref_56","first-page":"584","article-title":"Epidemiology and management of right ventricular-predominant heart failure and shock in the cardiac intensive care unit","volume":"11","author":"Kanwar","year":"2022","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.cardfail.2021.07.013","article-title":"Right Ventricular Dysfunction Is Common and Identifies Patients at Risk of Dying in Cardiogenic Shock","volume":"27","author":"Jain","year":"2021","journal-title":"J. Card. Fail."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3800","DOI":"10.1016\/S0735-1097(25)04284-6","article-title":"Rethinking right ventricular shock: Right ventricular assist device as a bailout strategy in cardiogenic shock after right ventricle infarction","volume":"85","author":"Stives","year":"2025","journal-title":"JACC"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1183\/09059180.00007414","article-title":"The right ventricle in pulmonary arterial hypertension","volume":"23","author":"Naeije","year":"2014","journal-title":"Eur. Respir. Rev."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1183\/09059180.00006511","article-title":"The role of the right ventricle in pulmonary arterial hypertension","volume":"20","year":"2011","journal-title":"Eur. Respir. Rev."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2401325","DOI":"10.1183\/13993003.01325-2024","article-title":"Treatment algorithm for pulmonary arterial hypertension","volume":"64","author":"Chin","year":"2024","journal-title":"Eur. Respir. J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.jcmg.2014.12.026","article-title":"RV Longitudinal Deformation Correlates With Myocardial Fibrosis in Patients With End-Stage Heart Failure","volume":"8","author":"Lisi","year":"2015","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"C283","DOI":"10.1093\/eurheartjsupp\/suad028","article-title":"Advanced heart failure: From definitions to therapeutic options","volume":"25","author":"Garascia","year":"2023","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e006894","DOI":"10.1161\/CIRCIMAGING.117.006894","article-title":"Prognostic Value of Right Ventricular Dysfunction in Heart Failure With Reduced Ejection Fraction: Superiority of Longitudinal Strain Over Tricuspid Annular Plane Systolic Excursion","volume":"11","author":"Carluccio","year":"2018","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.cardfail.2006.06.472","article-title":"Right ventricular dysfunction and adverse outcome in patients with advanced heart failure","volume":"12","author":"Field","year":"2006","journal-title":"J. Card. Fail."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1161\/CIRCHEARTFAILURE.109.900134","article-title":"Right ventricular response to intensive medical therapy in advanced decompensated heart failure","volume":"3","author":"Verhaert","year":"2010","journal-title":"Circ. Heart Fail."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"140","DOI":"10.15420\/cfr.2019.15.2","article-title":"Right Ventricular Failure: Pathophysiology, Diagnosis and Treatment","volume":"5","author":"Arrigo","year":"2019","journal-title":"Card. Fail. Rev."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Nasoufidou, A., Papazoglou, A.S., Stachteas, P., Karagiannidis, E., Samaras, A., Alexiou, S., Mourtzos, M.-A., Kassimis, G., and Fragakis, N. (2024). Intravenous Landiolol for Rate Control in Supraventricular Tachyarrhythmias in Patients with Left Ventricular Dysfunction: A Systematic Review and Meta-Analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13061683"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1002\/ejhf.478","article-title":"Contemporary management of acute right ventricular failure: A statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology","volume":"18","author":"Harjola","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_70","first-page":"304","article-title":"Diagnosis and treatment of right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale): A clinical consensus statement of the Association for Acute CardioVascular Care of the European Society of Cardiology","volume":"13","author":"Arrigo","year":"2024","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1177\/08850666231216889","article-title":"Right Heart Failure in the Intensive Care Unit: Etiology, Pathogenesis, Diagnosis, and Treatment","volume":"40","author":"Tarras","year":"2025","journal-title":"J. Intensive Care Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1093\/bja\/aeu394","article-title":"Caveats of pressure control: Lung non-protective ventilation","volume":"113","author":"McKechnie","year":"2014","journal-title":"Br. J. Anaesth."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s40635-021-00391-x","article-title":"Norepinephrine and dobutamine improve cardiac index equally by supporting opposite sides of the heart in an experimental model of chronic pulmonary hypertension","volume":"9","author":"Hyldebrandt","year":"2021","journal-title":"Intensive Care Med. Exp."},{"key":"ref_74","first-page":"426","article-title":"The medical treatment of cardiogenic shock: Cardiovascular drugs","volume":"27","author":"Levy","year":"2021","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1097\/01.CCM.0000120052.77953.07","article-title":"Effects of norepinephrine and dobutamine on pressure load-induced right ventricular failure","volume":"32","author":"Kerbaul","year":"2004","journal-title":"Crit. Care Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1056\/NEJMoa2026845","article-title":"Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock","volume":"385","author":"Mathew","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2045894018790905","DOI":"10.1177\/2045894018790905","article-title":"Levosimendan in pulmonary hypertension and right heart failure","volume":"8","author":"Hansen","year":"2018","journal-title":"Pulm. Circ."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1053\/j.jvca.2007.10.015","article-title":"Comparison of inhaled iloprost and nitric oxide in patients with pulmonary hypertension during weaning from cardiopulmonary bypass in cardiac surgery: A prospective randomized trial","volume":"22","author":"Winterhalter","year":"2008","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.amjcard.2010.11.030","article-title":"Comparison of inhaled nitric oxide versus oxygen on hemodynamics in patients with mitral stenosis and severe pulmonary hypertension after mitral valve surgery","volume":"107","author":"Fernandes","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/1074248419877409","article-title":"Treatment Discontinuation or Interruption in Pulmonary Arterial Hypertension","volume":"25","author":"Narechania","year":"2020","journal-title":"J. Cardiovasc. Pharmacol. Ther."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1007\/s00134-024-07618-x","article-title":"Management of cardiogenic shock: State-of-the-art","volume":"50","author":"Jung","year":"2024","journal-title":"Intensive Care Med."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Botti, G., Gramegna, M., Burzotta, F., Masiero, G., Briguori, C., Trani, C., Napodano, M., Scandroglio, A.M., Montorfano, M., and Tarantini, G. (2022). Impella RP for Patients with Acute Right Ventricular Failure and Cardiogenic Shock: A Subanalysis from the IMP-IT Registry. J. Pers. Med., 12.","DOI":"10.3390\/jpm12091481"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"43","author":"Humbert","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.21037\/jtd-20-2228","article-title":"Right ventricular failure after left ventricular assist device implantation: A review of the literature","volume":"13","author":"Massimi","year":"2021","journal-title":"J. Thorac. Dis."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"103613","DOI":"10.1016\/j.amsu.2022.103613","article-title":"Clinicopathological features of adult right-sided cardiac masses: Analysis of 19 cases","volume":"77","author":"Lahmidi","year":"2022","journal-title":"Ann. Med. Surg."},{"key":"ref_86","first-page":"60","article-title":"Masses in right side of the heart: Spectrum of imaging findings","volume":"91","author":"Pradella","year":"2020","journal-title":"Acta Biomed."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.echo.2022.12.022","article-title":"Echocardiographic Markers in the Diagnosis of Cardiac Masses","volume":"36","author":"Paolisso","year":"2023","journal-title":"J. Am. Soc. Echocardiogr."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1070\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T08:49:08Z","timestamp":1780303748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":87,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["medicina62061070"],"URL":"https:\/\/doi.org\/10.3390\/medicina62061070","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}