title: Physiological mechanisms of pulmonary hypertension.
abstract: Pulmonary hypertension is usually related to obstruction of pulmonary blood flow at the level of the pulmonary arteries (eg, pulmonary embolus), pulmonary arterioles (idiopathic pulmonary hypertension), pulmonary veins (pulmonary venoocclusive disease) or mitral valve (mitral stenosis and regurgitation). Pulmonary hypertension is also observed in heart failure due to left ventricle myocardial diseases regardless of the ejection fraction. Pulmonary hypertension is often regarded as a passive response to the obstruction to pulmonary flow. We review established fluid dynamics and physiology and discuss the mechanisms underlying pulmonary hypertension. The important role that the right ventricle plays in the development and maintenance of pulmonary hypertension is discussed. We use principles of thermodynamics and discuss a potential common mechanism for a number of disease states, including pulmonary edema, through adding pressure energy to the pulmonary circulation.
authors.affiliation: Biological Physics Group, School of Physics & Astronomy, University of Manchester, Manchester, United Kingdom; Department of Cardiology, Taunton & Somerset Hospital, Musgrove Park, Taunton, United Kingdom; Medical Education, University of Bristol, Senate House, Tyndall Avenue, Bristol, United Kingdom. Electronic address: david.maciver@tst.nhs.uk.
authors.forename: David H
authors.initials: DH
authors.lastname: MacIver
authors.affiliation: Biological Physics Group, School of Physics & Astronomy, University of Manchester, Manchester, United Kingdom.
authors.forename: Ismail
authors.initials: I
authors.lastname: Adeniran
authors.affiliation: Biological Physics Group, School of Physics & Astronomy, University of Manchester, Manchester, United Kingdom.
authors.forename: Iain R
authors.initials: IR
authors.lastname: MacIver
authors.affiliation: Modelling & Simulation Centre, School of Mechanical, Aerospace & Civil Engineering, University of Manchester, United Kingdom.
authors.forename: Alistair
authors.initials: A
authors.lastname: Revell
authors.affiliation: Biological Physics Group, School of Physics & Astronomy, University of Manchester, Manchester, United Kingdom.
authors.forename: Henggui
authors.initials: H
authors.lastname: Zhang
mesh_terms: D006801:Humans; D057446:Hydrodynamics; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D011652:Pulmonary Circulation / Q000502:physiology*; D013816:Thermodynamics