{
  "abstract": "Background: Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of all global heart failure cases. Historically viewed as a left‐centric diastolic disorder, emerging evidence identifies right ventricular (RV) dysfunction and impaired ventriculo‐arterial (RV‐PA) coupling as central drivers of exercise intolerance, functional decline, and adverse clinical outcomes.\n\nObjectives: This review synthesizes current evidence on the pathophysiological mechanisms, advanced diagnostic modalities, prognostic implications, and phenotype‐specific therapies for RV dysfunction in HFpEF, advocating for a transition to systematic biventricular evaluation.\n\nMethods: A structured, PRISMA‐informed search of PubMed and Scopus (2015–2024) identified 74 eligible studies evaluating RV structure, function, and hemodynamics in HFpEF cohorts.\n\nResults: RV dysfunction is prevalent in 19% to 33% of HFpEF patients and independently predicts all‐cause mortality and heart failure hospitalizations. Key pathophysiological drivers include post‐capillary pulmonary hypertension, impaired RV lusitropy, systemic inflammation, and inter‐ventricular dependence. Non‐invasive markers notably speckle‐tracking echocardiography, 4D‐flow cardiac magnetic resonance (CMR), and the TAPSE/PASP ratio enable early identification of subclinical RV‐PA uncoupling. While traditional heart failure therapies show limited efficacy, emerging options including SGLT2 inhibitors, interatrial shunt devices, GLP‐1 receptor agonists, and targeted pulmonary vasodilators demonstrate potential to preserve RV strain and restore hemodynamics across distinct clinical phenotypes.\n\nConclusions: RV dysfunction is a major prognostic marker in HFpEF. Routine inclusion of RV‐PA coupling indices in diagnostic and risk‐stratification algorithms is essential to guide precision‐based, phenotype‐guided management and improve clinical trajectories.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Medical Sciences, Lebanese University Beirut Lebanon",
    "Jinnah Sindh Medical University Karachi Pakistan",
    "Allama Iqbal Medical College Lahore Pakistan",
    "Foundation University Medical College Islamabad Pakistan",
    "Dow University of Health Sciences Karachi Pakistan",
    "Saidu Medical College Swat Pakistan",
    "Kakatiya Medical College Warangal Telangana India",
    "Khyber Girls Medical College Peshawar Pakistan",
    "Abbottabad International Medical College Abbottabad Pakistan",
    "Department of Molecular Medicine University of Pavia Italy",
    "Khyber Medical College Peshawar Pakistan",
    "Faculty of Medicine Medical University of Plovdiv Plovdiv Bulgaria",
    "Chief, Internal Medicine Department Nasrat Bashir Curative Hospital Kandahar Afghanistan"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Amarelle Chamoun",
      "orcid": "0000-0002-3473-8922"
    },
    {
      "affs": [
        1
      ],
      "name": "Talha Farooq",
      "orcid": "0009-0000-0737-9904"
    },
    {
      "affs": [
        2
      ],
      "name": "Suhayya Batool",
      "orcid": "0009-0000-2394-3210"
    },
    {
      "affs": [
        3
      ],
      "name": "Sadia Tameez‐ud—din",
      "orcid": "0009-0008-6383-7728"
    },
    {
      "affs": [
        2
      ],
      "name": "Muhammad Yousaf",
      "orcid": "0009-0006-0959-2892"
    },
    {
      "affs": [
        4
      ],
      "name": "Preet Memon",
      "orcid": "0009-0005-3682-8840"
    },
    {
      "affs": [
        5
      ],
      "name": "Mohsin Ali",
      "orcid": "0009-0006-4443-7046"
    },
    {
      "affs": [
        6
      ],
      "name": "Arun Kumar Maloth"
    },
    {
      "affs": [
        7
      ],
      "name": "F. N. U. Sawaira",
      "orcid": "0009-0002-9603-5656"
    },
    {
      "affs": [
        8
      ],
      "name": "Muhammad Taimur Khan",
      "orcid": "0009-0007-7616-9143"
    },
    {
      "affs": [
        9
      ],
      "name": "Mohammad Eisa Ali",
      "orcid": "0009-0007-9473-6607"
    },
    {
      "affs": [
        10
      ],
      "name": "Mansoor Khalid",
      "orcid": "0009-0007-7099-0125"
    },
    {
      "affs": [
        11
      ],
      "name": "Maleeha Pandit",
      "orcid": "0009-0009-8029-4363"
    },
    {
      "affs": [
        12
      ],
      "name": "Kamil Ahmad Kamil",
      "orcid": "0009-0000-8208-0689"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/15qv2ys5wnqme.bib",
  "cited_by": 0,
  "doi": "10.1002/clc.70489",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13723167/?tool=EBI",
  "id": "15qv2ys5wnqme",
  "issns": [
    "0160-9289",
    "1932-8737"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13723167",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "2705|Cardiovascular Function and Risk Factors"
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  "openalex": "W7224992997",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13723167/pdf/?tool=EBI",
  "pmcid": "PMC13723167",
  "pmid": "42965400",
  "published": "2026-10-31",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/15qv2ys5wnqme.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T03:21:51Z",
      "native_id": "PMC:PMC13723167",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13723167"
    },
    {
      "first_seen": "2026-11-04T12:21:49Z",
      "native_id": "PMC13723167",
      "source": "pmc",
      "url": "https://doi.org/10.1002/clc.70489"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiovascular Function and Risk Factors",
      "subfield": "cardiovascular"
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  ],
  "title": "Right Ventricular Dysfunction and Ventriculo‐Arterial Uncoupling in Heart Failure With Preserved Ejection Fraction: A Phenotype‐Specific Review of Mechanisms, Diagnosis, and Therapeutic Strategies",
  "title_text": "Right Ventricular Dysfunction and Ventriculo‐Arterial Uncoupling in Heart Failure With Preserved Ejection Fraction: A Phenotype‐Specific Review of Mechanisms, Diagnosis, and Therapeutic Strategies",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T12:21:49Z",
  "url": "https://research.draconitic.com/paper/15qv2ys5wnqme",
  "venue": "Clinical cardiology",
  "versions": []
}