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J. Am. Coll. Cardiol. · Dec 2013
ReviewRight 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, and Paul M Hassoun.
- Department of Pneumology, VU University Medical Center, Amsterdam, the Netherlands. Electronic address: a.vonk@vumc.nl.
- J. Am. Coll. Cardiol. 2013 Dec 24; 62 (25 Suppl): D22-33.
AbstractSurvival 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. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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