Pressure-overload-induced right heart failure.
Although pulmonary arterial hypertension originates in the lung and is caused by progressive remodeling of the small pulmonary arterioles, patients die from the consequences of pressure-overload-induced right heart failure. Prognosis is poor, and currently there are no selective treatments targeting the failing right ventricle. Therefore, it is of utmost importance to obtain more insights into the mechanisms of right ventricular adaptation and the transition toward right heart failure. In this review, we propose that the same adaptive mechanisms, which initially preserve right ventricular systolic function and maintain cardiac output, eventually initiate the transition toward right heart failure.
Department of Physiology, VU University Medical Center/Institute for Cardiovascular Research (ICaR-VU), Amsterdam, The Netherlands.
S
S
Rain
M L
ML
Handoko
A
A
Vonk Noordegraaf
H J
HJ
Bogaard
J
J
van der Velden
F S
FS
de Man
D000222:Adaptation, Physiological; D000818:Animals; D006019:Glycolysis; D006333:Heart Failure / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D006352:Heart Ventricles / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D017380:Hypertrophy, Right Ventricular / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D014655:Vascular Resistance