title: The right ventricle and pulmonary hypertension.
abstract: 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.
authors.affiliation: Department of Pulmonary Diseases, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Mariëlle C
authors.initials: MC
authors.lastname: van de Veerdonk
authors.affiliation: Department of Pulmonary Diseases, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Harm J
authors.initials: HJ
authors.lastname: Bogaard
authors.affiliation: The Victoria Johnson Pulmonary Research Laboratory, Virginia Commonwealth University, 1220 East Broad Street, Richmond, VA, 23298, USA. nfvoelkel@gmail.com.
authors.forename: Norbert F
authors.initials: NF
authors.lastname: Voelkel
mesh_terms: D000818:Animals; D005355:Fibrosis; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D000073436:Microvascular Rarefaction / Q000503:physiopathology; D009200:Myocardial Contraction; D051381:Rats; D012727:Sex Characteristics; D018497:Ventricular Dysfunction, Right / Q000150:complications*; D016278:Ventricular Function, Right; D020257:Ventricular Remodeling
keywords: Capillary rarefaction; Contractility; Fibrosis; Metabolism; Pulmonary hypertension; Right ventricular failure
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