Right ventricular-centered metabolomics: A promising tool for phenotyping pulmonary arterial hypertension

Recent advances in plasma metabolomics have highlighted the potential role of right ventricular–centered metabolic profiling in pulmonary arterial hypertension associated with atrial septal defect. By commenting on a trans-cardiac metabolomic gradient approach, this letter discusses how right ventricular metabolic signatures may reflect adaptive and maladaptive mechanisms beyond hemodynamic burden alone. We contextualize these findings within emerging evidence from lipidomics, endothelial biomarkers, and systemic disease models, emphasizing the translational value of integrating metabolomics into phenotyping and risk stratification strategies for pulmonary hypertension.