Pathophysiology of the right ventricle and its pulmonary vascular interaction
2024; European Respiratory Society; Volume: 64; Issue: 4 Linguagem: Inglês
10.1183/13993003.01321-2024
ISSN1399-3003
AutoresAnna R. Hemnes, David S Celermajer, Michele D’Alto, François Haddad, Paul M. Hassoun, Kurt W. Prins, Robert Naeije, Anton Vonk Noordegraaf,
Tópico(s)Cardiovascular Effects of Exercise
ResumoThe right ventricle and its stress response is perhaps the most important arbiter of survival in patients with pulmonary hypertension of many causes. The physiology of the cardiopulmonary unit and definition of right heart failure proposed in the 2018 World Symposium on Pulmonary Hypertension have proven useful constructs in subsequent years. Here, we review updated knowledge of basic mechanisms that drive right ventricular function in health and disease, and which may be useful for therapeutic intervention in the future. We further contextualise new knowledge on assessment of right ventricular function with a focus on metrics readily available to clinicians and updated understanding of the roles of the right atrium and tricuspid regurgitation. Typical right ventricular phenotypes in relevant forms of pulmonary vascular disease are reviewed and recent studies of pharmacological interventions on chronic right ventricular failure are discussed. Finally, unanswered questions and future directions are proposed.
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