Future Directions in Right Heart Disease: Emerging Trends and Innovations in Treatment
Introduction
Globally, cardiovascular disease appears to be the root cause of significant health issues. This circumstance urges innovative management and prevention strategies to reduce the risk of cardiovascular diseases [1]. Particularly, research related to left heart functioning is greater in number than studies related to right heart functioning. However, the phase has changed, and studies related to right heart diseases are on the rise, as it is identified that the right heart plays a major role in maintaining overall cardiovascular health. This article will discuss emerging trends and innovations in cardiac care that help in shaping its future.
Background and significance
Cardiovascular diseases encompass a range of conditions affecting the heart and blood vessels, leading to numerous health problems and fatalities worldwide. It covers diseases such as coronary artery disease, stroke, hypertension, and heart failure [1]. Heart failure occurs when the heart fails to pump blood due to blocked or narrowed coronary arteries to meet the body’s requirements. Researchers’ interest related to right heart’s physiology and pathophysiology has increased due to studies demonstrating the right heart size, its function and impact on cardiovascular diseases [2]. The function of the right ventricular determines the results of pulmonary hypertension in a patient, whether it is treated or untreated.
Studies show that mortality rate is high for patients with right heart dysfunction and left heart failure. In recent years, the right heart’s functional ability in patients with valvular heart disease has gained more attention [3].
Emerging Trends and Innovations in Treatment
Cardiac Imaging Innovations
There have been advancements in terms of imaging for detection and diagnosis of cardiovascular disease like the right heart disease. More recently, technologies including 3D echocardiography and magnetic resonance imaging (MRI) have been known to play a crucial role in diagnosis of right heart diseases. Hahn et al., (2023) assessed the dependency of cardiovascular disease s outcomes with the right ventricular size and function using multimodality imaging techniques [2]. However, further research is required to find the novel parameters affecting right ventricular function. Employing the latest technologies like AI and novel imaging modalities can further improve the assessment of right ventricular dysfunction.
Pharmacological interventions
Pharmacological interventions such as statins, antiplatelet agents, and antihypertensive drugs can be used to reduce the risk of developing heart diseases. These interventions along with lifestyle modifications can provide significant health benefits while also helping in prevention and management of cardiovascular diseases. Despite the health benefits, this intervention can cause serious health issues and potential side effects if left unattended. [1]. Therefore, essential care has to be taken considering individual need and associated risk while prescribing these interventions for heart diseases.
Emerging therapies
Numerous therapies are employed in treating heart failure including regenerative therapies, gene therapy, medical therapy, and device therapy. Regenerative therapies like stem cell therapy are novel treatment approaches used for repairing damaged heart tissue while improving heart function [1]. Gene therapy is also an emerging approach employed to change the gene makeup, to prevent or treat heart disease. Similarly, medical therapy and device therapy are used for treating heart failure. In addition, novel drug therapies have also shown promising results in treating heart functions by restoring stable cardiac function. This is achieved by replenishing depleted membrane proteins or regulating intracellular calcium levels. Some of the novel drugs used for this purpose are Ularitide, Tolvaptan, Serelaxin and few others.
Precision medicines
Investigation on individual responses to particular drugs, genetic variations potentially influence the drug response in various clinical settings. This method can identify patients’ heart failure risk earlier and offer tailored treatment based on their specific needs [4]. Further, using new technologies such as genomic sequencing and advanced imaging, healthcare providers can understand disease mechanisms thoroughly and create customized treatments targeting specific molecular pathways. For example, the PCSK9 inhibitors are given to individuals with familial hypercholesterolemia.
Future directions
| S.NO | Future direction | Scope | References |
| 1 | Personalized Medicine Approaches | Explore various factors affecting individuals and discover tailored treatments based on genetic and molecular profiling of right heart disease patients for optimized outcomes. | [4] |
| 2 | Next-Generation Mechanical Support Devices | Developing smaller, more efficient RVADs and other mechanical devices to provide long-term support for patients with chronic right heart failure. Additionally, these innovative devices should facilitate smart technology integration and personalized approaches. | [5] |
| 3 | Integration of Artificial Intelligence (AI) in Treatment | With advanced AI algorithms and machine learning, we can increase the accuracy and speed of diagnosis, providing personalized treatment by identifying the disease earlier. | [1] |
| 4 | Expanded use of 3D printing for surgical planning | Utilizing 3D printing we can preoperatively plan for complex surgical interventions in congenital heart disease. | [6][7] |
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Conclusion
Heart failure and its related health issues have been predominantly increasing in recent years due to various factors. Similarly, right heart dysfunction has also become a global health issue and gained much attention. Therefore, studies related to right heart dysfunctions are gaining prominence. Advanced technologies are employed to mitigate this problem through personalized treatment and diagnosis. However, there is a need for the adoption of latest technologies such as AI and ML, precision medicine, and novel therapies to significantly improve patient results and revolutionize disease management.
References
- Addissouky, T.A., El Sayed, I.E.T., Ali, M.M., Wang, Y., El Baz, A., Elarabany, N. and Khalil, A.A. (2024) Shaping the future of cardiac wellness: exploring revolutionary approaches in disease management and prevention. Journal of Clinical Cardiology, 5(1), pp.6-29.
- Hahn, R.T., Lerakis, S., Delgado, V., Addetia, K., Burkhoff, D., Muraru, D., Pinney, S. and Friedberg, M.K. (2023) Multimodality imaging of right heart function: JACC scientific statement. Journal of the American College of Cardiology, 81(19), pp.1954-1973.
- Brener, M.I., Lurz, P., Hausleiter, J., Rodés-Cabau, J., Fam, N., Kodali, S.K., Rommel, K.P., Muntané-Carol, G., Gavazzoni, M., Nazif, T.M. and Pozzoli, A., (2022) Right ventricular-pulmonary arterial coupling and afterload reserve in patients undergoing transcatheter tricuspid valve repair. Journal of the American College of Cardiology, 79(5), pp.448-461.
- Kumar, R.S., Gopalakrishnan, S., Narendran, M. and Aravazhi, R. (2023) Emerging Frontiers in Pharmacological Interventions for Heart Failure: A Comprehensive Review of Recent Advances in Chronic Heart Failure Therapy. Int J Acad Med Pharm, 5(4), pp.1040-1046.
- Meng, F., Zhu, Y. and Yang, M. (2024) Hemodynamic effects of pulsatile frequency of right ventricular assist device (RVAD) on pulmonary perfusion: a simulation study. Medical & Biological Engineering & Computing, pp.1-11.
- Masoumkhani, F., Fallah, A., Amani-Beni, R., Mohammadpour, H., Shahbazi, T. and Bakhshi, A. (2024) 3D printing for cardiovascular surgery and intervention: A review article. Current Problems in Cardiology, 49(1), p.102086.
- Suvorov, V., Loboda, O., Balakina, M. and Kulczycki, I. (2023) A New Three-Dimensional (3D) Printing Prepress Algorithm for Simulation of Planned Surgery for Congenital Heart Disease. Congenital Heart Disease, 18(5).
