The right heart and its distinct mechanisms of development, function, and failure

Congestive heart failure is the most common cause of hospitalization in the United States for people over the age of sixty-five. As the population ages, the morbidity and mortality from heart failure will become more prevalent. Left heart failure has been, and continues to be, extensively studied. However, a recent report from the National Heart, Lung, and Blood Institute suggests that the right heart has been relatively under-investigated, and unfortunately, most of the basic mechanisms of intracellular signaling within the right heart still remain poorly understood. Right heart failure is now being increasingly recognized as distinctly different from left heart failure, and an important mediator of overall cardiovascular collapse. The purpose of this review, therefore, is to discuss the current understanding of right heart cellular development, physiology, and pathophysiology, as well as to review therapeutic interventions that are both currently available and under investigation.