2017
DOI: 10.1007/s11897-017-0370-8
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Abstract: Purpose of review Visceral venous congestion of the gut may play a key role in the pathogenesis of right-sided heart failure (HF) and cardiorenal syndromes. Here we review the role of right ventricular (RV) dysfunction, visceral congestion, splanchnic hemodynamics, and the intestinal microenvironment in the setting of right-sided HF. We review recent literature on this topic, outline possible mechanisms of disease pathogenesis, and discuss potential therapeutics. Recent Findings There are several mechanisms … Show more

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Cited by 45 publications
(33 citation statements)
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“…Progressive venous congestion from RV dysfunction leads to impairment of renal, hepatic and intestinal function, resulting in increased morbidity and mortality [15]. Therefore, the elevated inflammatory markers in our patient could also be due to the presence of hepatic and splenic congestion in right ventricular (RV) failure.…”
Section: Discussionmentioning
confidence: 83%
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“…Progressive venous congestion from RV dysfunction leads to impairment of renal, hepatic and intestinal function, resulting in increased morbidity and mortality [15]. Therefore, the elevated inflammatory markers in our patient could also be due to the presence of hepatic and splenic congestion in right ventricular (RV) failure.…”
Section: Discussionmentioning
confidence: 83%
“…Therefore, the elevated inflammatory markers in our patient could also be due to the presence of hepatic and splenic congestion in right ventricular (RV) failure. Polsinelli et al (2017) and Sandek et al (2008) in reviewing RV-gut interactions in patients with heart failure, proposed that visceral venous congestion could result in hypoxia and acidosis in enterocytes, alteration of the gut microbiome leading to increased gut permeability and inflammation and alteration of renal haemodynamics with triggering of the cardiorenal syndrome [15,16]. Hence, effective management of acute RV dysfunction requires accurate assessment of RV preload, contractility and afterload.…”
Section: Discussionmentioning
confidence: 99%
“…Fourth, elevated central venous pressure is associated with renal, hepatic, and bowel congestion. Systemic venous congestion has been associated with impaired renal function and diuretic resistance . Decompression of central venous pressure may promote renal function and improve diuretic responsiveness, thereby leading to earlier decongestion of patients with acutely decompensated heart failure.…”
Section: Discussionmentioning
confidence: 99%
“…Systemic venous congestion has been associated with impaired renal function and diuretic resistance. [15][16][17][18] Decompression of central venous pressure may promote renal function and improve diuretic responsiveness, thereby leading to earlier decongestion of patients with acutely decompensated heart failure. This early proof of concept study is the first to identify that simply inflating a balloon and temporarily occluding flow in the SVC rapidly decompresses both the right and left ventricles without reducing systemic blood pressure or decreasing cardiac output.…”
Section: Discussionmentioning
confidence: 99%
“…Right ventricular dysfunction in acute decompensated heart failure is a major driver of poor prognosis . Overt right heart failure leads to systemic venous congestion and multi‐organ dysfunction . As mentioned by Dr. Arques, increased right‐sided filling pressures and concomitant coronary venous hypertension in decompensated heart failure may also lead to passive interstitial accumulation of fluids in the myocardium.…”
mentioning
confidence: 99%