The stressed right ventricle and its impact on the left ventricle

Mark K. Friedberg

Research output: ThesisDoctoral ThesisExternal prepared

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The heart’s job is to pump blood, which it does through contraction of the heart muscle. The right heart ventricle (RV) pumps blood to the lungs, the left ventricle (LV) pumps to the body. Pulmonary hypertension (PAH) is a fatal disease in which the RV fails (the muscle tires out) from having to pump against too much pressure. Tetralogy of Fallot (TOF) is a disease that reduces life quality and expectancy because the RV fails from too much blood volume. Current therapies focus almost entirely on reducing lung pressures or RV volume but are limited. While PAH and TOF are traditionally considered ‘right heart’ diseases, LV function also determines how well patients do. However, it is not exactly understood how the RV harms the LV and how the apparently paradoxical effect of increasing LV pressure reduces its injury. This knowledge is vital to apply new therapies. While many investigators believe that the stressed RV just exerts pressure on the LV to reduce its filling (think of a large crowd in a bus pushing passengers towards the door), this researcher thinks that the damage is more profound, extending to muscle injury (think of people being crushed). While current therapies akin to opening the bus door may improve the situation, they have not been enough to truly treat it (opening the bus door would not be ample to resuscitate crushed and injured passengers). This thesis investigates the mechanical and molecular mechanisms driving injury in the stressed RV and how these impact the LV.
Original languageEnglish
Awarding Institution
  • Maastricht University
  • Prinzen, Frits, Supervisor
  • Lumens, Joost, Co-Supervisor
  • Meijboom, F.J., Co-Supervisor, External person
Award date21 Apr 2021
Place of PublicationMaastricht
Print ISBNs9789464191691
Publication statusPublished - 2021


  • right ventricle
  • ventricular-ventricular interaction
  • right ventricular pressure-loading
  • electromechanical dyssynchrony

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