Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology

Anton Vonk-Noordegraaf; François 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

doi:10.1016/j.jacc.2013.10.027

Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology

Anton Vonk-Noordegraaf^*, François 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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

Original language	English
Pages (from-to)	D22-33
Journal	Journal of the American College of Cardiology
Volume	62
Issue number	25 Suppl
DOIs	https://doi.org/10.1016/j.jacc.2013.10.027
Publication status	Published - 24 Dec 2013

Keywords

Adaptation, Physiological
Animals
Familial Primary Pulmonary Hypertension
Humans
Hypertension, Pulmonary
Ventricular Dysfunction, Right
Ventricular Function, Right
Ventricular Remodeling
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Review

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Vonk-Noordegraaf, A., Haddad, F., Chin, K. M., Forfia, P. R., Kawut, S. M., Lumens, J., Naeije, R., Newman, J., Oudiz, R. J., Provencher, S., Torbicki, A., Voelkel, N. F., & Hassoun, P. M. (2013). Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology. Journal of the American College of Cardiology, 62(25 Suppl), D22-33. https://doi.org/10.1016/j.jacc.2013.10.027

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title = "Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology",

abstract = "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.",

keywords = "Adaptation, Physiological, Animals, Familial Primary Pulmonary Hypertension, Humans, Hypertension, Pulmonary, Ventricular Dysfunction, Right, Ventricular Function, Right, Ventricular Remodeling, Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S., Review",

author = "Anton Vonk-Noordegraaf and Fran{\c c}ois Haddad and Chin, {Kelly M} and Forfia, {Paul R} and Kawut, {Steven M} and Joost Lumens and Robert Naeije and John Newman and Oudiz, {Ronald J} and Steve Provencher and Adam Torbicki and Voelkel, {Norbert F} and Hassoun, {Paul M}",

year = "2013",

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doi = "10.1016/j.jacc.2013.10.027",

language = "English",

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journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier Science",

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Vonk-Noordegraaf, A, Haddad, F, Chin, KM, Forfia, PR, Kawut, SM, Lumens, J, Naeije, R, Newman, J, Oudiz, RJ, Provencher, S, Torbicki, A, Voelkel, NF & Hassoun, PM 2013, 'Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology', Journal of the American College of Cardiology, vol. 62, no. 25 Suppl, pp. D22-33. https://doi.org/10.1016/j.jacc.2013.10.027

TY - JOUR

T1 - Right heart adaptation to pulmonary arterial hypertension

T2 - physiology and pathobiology

AU - Vonk-Noordegraaf, Anton

AU - Haddad, François

AU - Chin, Kelly M

AU - Forfia, Paul R

AU - Kawut, Steven M

AU - Lumens, Joost

AU - Naeije, Robert

AU - Newman, John

AU - Oudiz, Ronald J

AU - Provencher, Steve

AU - Torbicki, Adam

AU - Voelkel, Norbert F

AU - Hassoun, Paul M

PY - 2013/12/24

Y1 - 2013/12/24

N2 - 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.

AB - 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.

KW - Adaptation, Physiological

KW - Animals

KW - Familial Primary Pulmonary Hypertension

KW - Humans

KW - Hypertension, Pulmonary

KW - Ventricular Dysfunction, Right

KW - Ventricular Function, Right

KW - Ventricular Remodeling

KW - Journal Article

KW - Research Support, N.I.H., Extramural

KW - Research Support, U.S. Gov't, Non-P.H.S.

KW - Review

U2 - 10.1016/j.jacc.2013.10.027

DO - 10.1016/j.jacc.2013.10.027

M3 - Article

C2 - 24355638

SN - 0735-1097

VL - 62

SP - D22-33

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 25 Suppl

ER -

Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology

Abstract

Keywords

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