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The impact of right ventricular function on the heart failure prognosis and survival in cardiac surgery

Authors: Averina I.I., Mironenko M.Yu., Glushko L.A., Troshin D.S., Donakanyan S.A.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2025-19-1-35-44

For citation: Averina I.I., Mironenko M.Yu., Glushko L.A., Troshin D.S., Donakanyan S.A. The impact of right ventricular function on the heart failure prognosis and survival in cardiac surgery. Creative Cardiology. 2025; 19 (1): 35–44 (in Russ.). DOI: 10.24022/1997- 3187-2025-19-1-35-44

Received / Accepted:  20.02.2025 / 10.03.2025

Keywords: right ventricular failure biventricular heart failure right ventricular function cardiac surgery prognosis



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Abstract

Acute right ventricular failure is a complex clinical syndrome, a transition point to terminal heart failure (HF), often occurs after cardiac surgery, determining an worse prognosis. The pathological cascade leads to increased venous congestion in the systemic circulation, progression of biventricular HF, decreased quality of life, increased hospitalization and mortality. Dysfunction of the right ventricle (RV) after cardiac surgery has its own characteristics. The evolution of RV function

indices is presented: from measuring global and free wall RV strain, tricuspid annulus motion amplitude (TAPSE) to indices reflecting the relationship – dependence of RV function on the state of the pulmonary circulation (increased pulmonary artery pressure). Increasing patient survival after cardiac surgery requires not only a deep understanding of the pathophysiology of biventricular failure, organ dysfunction, but also the ability to stratify patients at high risk of death and HF progression using new indices.

Future research should be aimed at developing new treatment approaches given the complexity of RV hemodynamics and the lack of randomized trials with convincing evidence of treatment efficacy.

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About Authors

  • Irina I. Averina, Dr. Med. Sci., Senior Researcher, Сardiologist; ORCID
  • Marina Yu. Mironenko, Cand. Med. Sci., Head of Department; ORCID
  • Lyudmila A. Glushko, Cand. Med. Sci., Head of the Lung Sampling and Gas Exchange Monitoring Group; ORCID
  • Dmitriy S. Troshin, Postgraduate, Сardiologist; ORCID
  • Sergey A. Donakanyan, Dr. Med. Sci., Professor, Head of Department; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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