Right Heart Adaptation to Pulmonary Arterial聽Hypertension: Physiology and Pathobiology

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• 作者：Anton Vonk-Noordegraaf ; Fran莽ois 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
• 关键词：echocardiography ; heart failure ; MRI ; myocardium ; pulmonary artery hypertension ; right ventricle
• 刊名：Journal of the American College of Cardiology
• 出版年：24 December, 2013
• 年：2013
• 卷：62
• 期：25_supp_S
• 页码：D22-D33
• 全文大小：953 K

文摘

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.