The appreciation of the right ventricle (RV) can be traced to the work of William Harvey with his landmark publication Exercitatio Anatomica de Motu Cordis et sanguinis in Animabilus in 1628, in which based on observations and experiments, Harvey had the incredible insight to differentiate the functions of the two ventricles when he stated: “So it appears that whereas one ventricle, the left, suffices for distributing the blood to the body and drawing it from the vena cava, as is the case in all animals lacking lungs, nature was compelled when she wished to filter blood through the lungs to add the right ventricle. Thus the right ventricle may be said to be made for the sake of transmitting blood through the lungs, not for nourishing them.”
Though Harvey's keen observations on the human circulatory system have been credited as the beginnings of modern cardiology, the right heart system has been vastly neglected during the last half century of advances in cardiology as most of the attention has been given to the left heart. However, as the recognition of the pivotal role the right heart system plays in determining outcome among patients presenting with cardiopulmonary disease increases, the pendulum is shifting toward focusing our learning more about the mechanism, pathophysiology, evaluation, and management of right heart dysfunction.
It is my distinct honor to present this issue which highlights key principles in clinical dilemmas in the management of patients with right heart failure in the critical care setting. I am very grateful to our guest editor Deborah Levine, MD, for bringing together a renowned group of experts to collectively share their experiences in the management of this challenging group of patients. Their expertise and insight provide valuable information for clinicians at the bedside as they encounter this unique group of critically ill patients.
On a personal note, I wish to thank the Advances editorial board, PHA leadership and staff, our guest editors and authors, and our managing editor Deb McBride for all the tremendous support I have received during the past 2 years as editor-in-chief. Thanks to everyone's contributions, we have been able to successfully implement several key changes within Advances including:
increasing the number of editorial board members
redesigning Advances as a scholarly journal
instituting more rigorous peer review in keeping with NLM standards
providing commentary from the editor-in-chief with each issue's eTOC
preparing for the re-launch of research updates
welcoming a terrific new section, PH Grand Rounds
Through all these efforts, we remain steadfast in our goal to serve the PH clinical community to help in the care and management of patients with pulmonary hypertension. As I welcome the incoming editor-in-chief, Charles Burger, MD, I would like to thank you, our readers, for all the support I have received in serving Advances. It has been a true honor and privilege.