HFSA Scientific Statement on Right Heart Failure

Right heart failure (RHF), both acute and chronic is increasingly recognized as a distinct and clinically significant syndrome across the spectrum of cardiovascular disease. Estimates suggest RHF complicates >25-30% of hospitalizations for acute decompensated HF and is nearly universal in advanced pulmonary hypertension (PH) (1) Despite recent diagnostic and therapeutic advancements, RHF remains associated with substantial morbidity, mortality, and impaired quality of life. Addressing RHF requires dedicated strategies tailored to its pathophysiology, including early identification, risk stratification, and novel therapies. (2) While randomized controlled trials (RCTs) on the topic remain limited, there has been increasing emphasis on early recognition and management of RHF (especially in the setting of left ventricular [LV] failure). In addition, there is an expanding role for temporary mechanical circulatory support (MCS) in acute RHF and percutaneous tricuspid interventions in chronic RHF. Yet, the field remains limited by its under-recognition, lack of standardized definitions, and limited therapeutic options, which underscore the urgent need for consensus and guidance.