2014
DOI: 10.1183/09059180.00007414
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The right ventricle in pulmonary arterial hypertension

Abstract: Pulmonary arterial hypertension (PAH) is a right heart failure syndrome. In early-stage PAH, the right ventricle tends to remain adapted to afterload with increased contractility and little or no increase in right heart chamber dimensions. However, less than optimal right ventricular (RV)-arterial coupling may already cause a decreased aerobic exercise capacity by limiting maximum cardiac output. In more advanced stages, RV systolic function cannot remain matched to afterload and dilatation of the right heart … Show more

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Cited by 203 publications
(140 citation statements)
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References 64 publications
(86 reference statements)
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“…These animals present elevated Hct and Hb levels, a right ventricular hypertrophy (a sign of pulmonary hypertension), an altered alveolar structure with enlarged airspaces in the lungs, and impaired respiratory control (Lumbroso et al, 2012). Considering that elevated Hct and pulmonary hypertension impair survival and lead to right heart failure (Lumbroso et al, 2012;Naeije and Manes, 2014;Storz et al, 2010b), this might explain why rats have not been able to establish stable colonies in high altitude regions under natural conditions.…”
Section: Introductionmentioning
confidence: 99%
“…These animals present elevated Hct and Hb levels, a right ventricular hypertrophy (a sign of pulmonary hypertension), an altered alveolar structure with enlarged airspaces in the lungs, and impaired respiratory control (Lumbroso et al, 2012). Considering that elevated Hct and pulmonary hypertension impair survival and lead to right heart failure (Lumbroso et al, 2012;Naeije and Manes, 2014;Storz et al, 2010b), this might explain why rats have not been able to establish stable colonies in high altitude regions under natural conditions.…”
Section: Introductionmentioning
confidence: 99%
“…Although proofed to regulate the development of VSDs and hypoplasia during early stages of life and embryogenesis, this miR could also play a role in the development of CH e.g., in patients with prolonged nontreated larger septal defects, respectively. Since larger VSDs or AVSDs (atrioventricular septal defects) can lead to elevated pulmonary pressure, a commonly known cause of CH (128), this miR might be differentially expressed or could be reactivated later in life, thus regulating CH. However, the distinct role of miR-195, especially in patients with VSD and pulmonary hypertension still has to be evaluated as well as the possibility of regulating this miR therapeutically by anti-sense strategies.…”
Section: Regulation Of Hypertrophymentioning
confidence: 99%
“…In addition, homeometric adaptation follows within minutes, referred to as the so called Anrep phenomenon. This refers to increases in contractility attributed to the neurohormones [4].…”
Section: Right Heart Failurementioning
confidence: 99%
“…Relaxation of the right ventricle occurs late and virtually coincides with atrial contraction. The low-pressure system ensures myocardial perfusion both during diastole and systole [4]. The right heart is connected to the left heart serially and shares with it the interatrial and interventricular septa and the pericardial space, causing marked ventricular interdependence [5].…”
Section: Determinants Of Right Heart Performancementioning
confidence: 99%
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