TY - JOUR
T1 - The right ventricle and pulmonary hypertension
AU - van de Veerdonk, Marielle C.
AU - Bogaard, Harm J.
AU - Voelkel, Norbert F.
N1 - Funding Information: Dr. M.C. van de Veerdonk declares that she has no conflicts of interest or financial ties to disclose. Dr. H.J. Bogaard receives speaker fees form Actelion, Pfizer, Bayer and is part of the advisory board of United Therapeutics and has received grant support from Boehringer Ingelheim and the Lung Foundation. Dr. N.F. Voelkel is part of the advisory board of Actelion and is a consultant at Insmed. Funding Information: We acknowledge the support from the Netherlands CardioVascular Research Initiative, the Dutch Heart Foundation, Dutch Federation of University Medical Centres, the Netherlands Organisation for Health Research and Development, and the Royal Netherlands Academy of Sciences. Publisher Copyright: © 2016, Springer Science+Business Media New York.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - In patients with pulmonary hypertension (PH), the primary cause of death is right ventricular (RV) failure. Improvement in RV function is therefore one of the most important treatment goals. In order to be able to reverse RV dysfunction and also prevent RV failure, a detailed understanding of the pathobiology of RV failure and the underlying mechanisms concerning the transition from a pressure-overloaded adapted right ventricle to a dilated and failing right ventricle is required. Here, we propose that insufficient RV contractility, myocardial fibrosis, capillary rarefaction, and a disturbed metabolism are important features of a failing right ventricle. Furthermore, an overview is provided about the potential direct RV effects of PH-targeted therapies and the effects of RV-directed medical treatments.
AB - In patients with pulmonary hypertension (PH), the primary cause of death is right ventricular (RV) failure. Improvement in RV function is therefore one of the most important treatment goals. In order to be able to reverse RV dysfunction and also prevent RV failure, a detailed understanding of the pathobiology of RV failure and the underlying mechanisms concerning the transition from a pressure-overloaded adapted right ventricle to a dilated and failing right ventricle is required. Here, we propose that insufficient RV contractility, myocardial fibrosis, capillary rarefaction, and a disturbed metabolism are important features of a failing right ventricle. Furthermore, an overview is provided about the potential direct RV effects of PH-targeted therapies and the effects of RV-directed medical treatments.
KW - Capillary rarefaction
KW - Contractility
KW - Fibrosis
KW - Metabolism
KW - Pulmonary hypertension
KW - Right ventricular failure
UR - http://www.scopus.com/inward/record.url?scp=84971620532&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10741-016-9526-y
DO - https://doi.org/10.1007/s10741-016-9526-y
M3 - Article
C2 - 26833318
SN - 1382-4147
VL - 21
SP - 259
EP - 271
JO - Heart Failure Reviews
JF - Heart Failure Reviews
IS - 3
ER -