Right heart adaptation to pulmonary arterial hypertension: Physiology and pathobiology

Anton Vonk-Noordegraaf, François Haddad, Kelly M. Chin, Paul R. Forfia, Steven M. Kawut, Joost Lumens, Robert Naeije, John Newman, Ronald J. Oudiz, Steve Provencher, Adam Torbicki, Norbert F. Voelkel, Paul M. Hassoun

Research output: Contribution to journalArticlepeer-review

462 Scopus citations

Abstract

Survival in patients with pulmonary arterial hypertension (PAH) is closely related to right ventricular (RV) function. Although pulmonary load is an important determinant of RV systolic function in PAH, there remains a significant variability in RV adaptation to pulmonary hypertension. In this report, the authors discuss the emerging concepts of right heart pathobiology in PAH. More specifically, the discussion focuses on the following questions. 1) How is right heart failure syndrome best defined? 2) What are the underlying molecular mechanisms of the failing right ventricle in PAH? 3) How are RV contractility and function and their prognostic implications best assessed? 4) What is the role of targeted RV therapy? Throughout the report, the authors highlight differences between right and left heart failure and outline key areas of future investigation.

Original languageEnglish (US)
Pages (from-to)D22-D33
JournalJournal of the American College of Cardiology
Volume62
Issue number25 SUPPL.
DOIs
StatePublished - Dec 24 2013

Keywords

  • MRI
  • echocardiography
  • heart failure
  • myocardium
  • pulmonary artery hypertension
  • right ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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