Rightventricularfailure(RVF)remainstheprimarycauseofdeathinpatientswithpulmonaryarterialhypertension.WereviewthepathophysiologyofRVF,includingtheremodelingandventriculoarterialuncouplingthatoccurswhenthefailingrightsideoftheheartisunabletocompensateforarisingafterload.Secondly,thenoninvasiveimagingtechniquesusedintheassessmentofRVFareexplored,includingechocardiography,cardiacmagneticresonanceimaging,computedtomography,andpositronemissiontomography.Third,wedescribehowtheseimagingtechniquesandapatient’sclinicalcharacteristicsmaybeusedtodetermineprognosis.Lastly,weexplorethemedicalandsurgical/interventionaltreatmentoptionsforRVF.Despitethesetreatmentoptions,morbidityandmortalityremainhighinthispatientpopulation.Thediscoveryofnewprognosticindicators,useofhybridimagingforearlydetectionofRVF,andstrategiestopreventthedevelopmentofRVFwillbeimportantifoutcomesinthispatientpopulationaretoimprove.
