Advancing knowledge of right ventricular pathophysiology in chronic pressure overload: Insights from experimental studies

Guihaire, Julien; Noly, Pierre‐Emmanuel; Schrepfer, Sonja; Mercier, Olaf

doi:10.1016/j.acvd.2015.05.008

Cited by 19 publications

(8 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The LVW increases by24. Such divergences of ventricular remodeling are due to anatomical and functional features: LV works as a pressure pump, and RV -as volumetric 15,16 . Inaddition, reducing the oncotic pressure of blood plasma causes swelling of the interstitium of the lungs, compressing the pulmonary vessels.…”

Section: Methodsmentioning

confidence: 99%

Age-dependent cardioprotective action of meldonium on heart remodeling under the experimental hypoosmolar hyperhydration

Yarmolenko

Vitaliy

Bumeister

et al. 2019

Bangladesh J Med Sci

View full text Add to dashboard Cite

Background: Chronic water overload leads to a remodeling of the internal organs, in particular the heart. The reaction of the organism to the influence of the damaging factors varies depending on age. Therefore, the complex treatment of diseases, which results in a positive water balance, requires the prescription of cardioprotectors.The aim of our study was the determination of morphological changes of the heart of rats of different age under the influence of hypoosomolar hyperhydration and an attempt to correct the detected changes by means of meldonium. Material and Method:The experiment was conducted on 36 laboratory male rats of two age groups: young (3 months old), and old (22 months old).Modeling of severe degree ofhypoosmolarhyperhydration was by the introduction of 10 ml distilled water three times a day and synthetic analogue of antidiuretic hormone «Minirin» (Ferring) 2 times a day at a dose of 0.01 mg without meldonium (first experimental series) and with the parallel introduction of meldonium (second experimental series). We analyzed organometric and histomorphometric data to study the features ofthe heart remodeling. Results: The organometric study indicated a uniform increase in the weight of the ventricles and a significant dilatation of the right ventricular cavity in young ratsof the first experimental series, and there was a predominant increase in the weight of the right ventricle and uniform dilatation of the cavities of both ventricles in old animals of the same series. The histomorphometric study has determined increasing in the diameter of cardiomyocytes and their nuclei in both age groups. We observed increasing in the relative amount of cardiomyocytes and vessels, and decreasing in relative amount of connective tissue in young rats. In contrast, there was decreasing in relative amount of cardiomyocytes and vessels, and increasing in the relative amount of connective tissue in old animals. The meldonium administration positively acts on the right ventricle, slowing its dilatation in young rats of the second experimental series and its hypertrophy in old rats. Moreover, the diameter of cardiomyocytes in both age groups is significantly increased, but meldonium stabilizes the diameter of the nuclei of cardiomyocytes. Also meldonium increases in the relative amount of vessels in 3-month age rats. Conclusions: The use of meldonium to correct the morphofunctional state of myocardium in rats under the influence of severe degree of Hypoosmolar hyperhydration significantly reduces the damaging effect of water overload on the myocardium of young animals, and to a lesser extent, on the myocardium of animals of old age. The positive effect of meldonium on the heart of experimental rats is to enhance myocardial vascularization, slowing the growth of the weight of the chambers of the heart, and slowing the dilation of ventricular cavities.

show abstract

Section: Methodsmentioning

confidence: 99%

Age-dependent cardioprotective action of meldonium on heart remodeling under the experimental hypoosmolar hyperhydration

Yarmolenko

Vitaliy

Bumeister

et al. 2019

Bangladesh J Med Sci

View full text Add to dashboard Cite

show abstract

“…It represents the maximal efficiency between stroke work and myocardial oxygen consumption. RV-PA coupling can be assessed using pressure-volume loops as the ratio between RV end-systolic elastance (Ees) and pulmonary arterial elastance (Ea) [ 2 , 39 ]. Ventricular-arterial uncoupling is defined as Ees/Ea ratio below 1.…”

Section: The Parallel Between Rv Remodeling In Pulmonary Hypertensmentioning

confidence: 99%

“…When the elevated afterload is too high, RV stroke volume and RV ejection fraction decrease. Uncoupling therefore occurs, followed by RV dilation and failure [ 2 , 40 , 41 ]. Because pressure-volume loops assessment is invasive and time-consuming and may be dangerous for PH patients because of the need for transient but repeated occlusions of the inferior vena cava, this remains dedicated to experimental studies.…”

Section: The Parallel Between Rv Remodeling In Pulmonary Hypertensmentioning

confidence: 99%

“…Recent emphasis on pulmonary hypertension (PH) has underscored the need for a better knowledge of the right ventricle mainly because studies have shown that left ventricular (LV) failure pathophysiology cannot be extrapolated to the right ventricle [ 1 , 2 ]. Right ventricular (RV) physiology in health and disease has been gained thanks to studies in patients with pulmonary hypertension (PH) [ 3 ] and congenital heart disease (CHD) [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Current Knowledge and Recent Advances of Right Ventricular Molecular Biology and Metabolism from Congenital Heart Disease to Chronic Pulmonary Hypertension

Guimaron

Guihaire

Amsallem

et al. 2018

BioMed Research International

Self Cite

View full text Add to dashboard Cite

Studies about pulmonary hypertension and congenital heart diseases have introduced the concept of right ventricular remodeling leading these pathologies to a similar outcome: right ventricular failure. However right ventricular remodeling is also a physiological process that enables the normal fetal right ventricle to adapt at birth and gain its adult phenotype. The healthy mature right ventricle is exposed to low pulmonary vascular resistances and is compliant. However, in the setting of chronic pressure overload, as in pulmonary hypertension, or volume overload, as in congenital heart diseases, the right ventricle reverts back to a fetal phenotype to sustain its function. Mechanisms include angiogenic changes and concomitant increased metabolic activity to maintain energy production. Eventually, the remodeled right ventricle cannot resist the increased afterload, leading to right ventricular failure. After comparing the fetal and adult healthy right ventricles, we sought to review the main metabolic and cellular changes occurring in the setting of PH and CHD. Their association with RV function and potential impact on clinical practice will also be discussed.

show abstract

“…Pathways determining those changes are not well known yet. However, it seems that they are probably triggered and maintained by inflammation, by neutrophils and ILs, oxidative stress, systemic and local neurohormonal factors, and ischemia ( 38 , 42 , 43 ). Despite many structural abnormalities happen, it seems that these modifications are, at least partially reversible, as it is well known that cardiac function improves after lungs transplantation or endarterectomy ( 42 ).…”

Section: Right Ventricular Physiopathologymentioning

confidence: 99%

Pulmonary Hypertension and Indicators of Right Ventricular Function

et al. 2016

View full text Add to dashboard Cite

Pulmonary hypertension (PH) is a rare disease, whose underlying mechanisms are not fully understood. It is characterized by pulmonary arterial vasoconstriction and vessels wall thickening, mainly intimal and medial layers. Several molecular pathways have been studied, but their respective roles remain unknown. Cardiac repercussions of PH are hypertrophy, dilation, and progressive right ventricular dysfunction. Multiple echocardiographic parameters are being used, in order to assess anatomy and cardiac function, but there are no guidelines edited about their usefulness. Thus, it is now recommended to associate the best-known parameters, such as atrial and ventricular diameters or tricuspid annular plane systolic excursion. Cardiac catheterization remains necessary to establish the diagnosis of PH and to assess pulmonary hemodynamic state. Concerning energetic metabolism, free fatty acids, normally used to provide energy for myocardial contraction, are replaced by glucose uptake. These abnormalities are illustrated by increased 18F-fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography/computed tomography, which seems to be correlated with echocardiographic and hemodynamic parameters.

show abstract

Advancing knowledge of right ventricular pathophysiology in chronic pressure overload: Insights from experimental studies

Cited by 19 publications

References 91 publications

Age-dependent cardioprotective action of meldonium on heart remodeling under the experimental hypoosmolar hyperhydration

Age-dependent cardioprotective action of meldonium on heart remodeling under the experimental hypoosmolar hyperhydration

Current Knowledge and Recent Advances of Right Ventricular Molecular Biology and Metabolism from Congenital Heart Disease to Chronic Pulmonary Hypertension

Pulmonary Hypertension and Indicators of Right Ventricular Function

Contact Info

Product

Resources

About