Right ventricular failure due to chronic pressure load: What have we learned in animal models since the NIH working group statement?

Heart Failure Reviews
Marinus A J BorgdorffBeatrijs Bartelds

Abstract

Right ventricular (RV) failure determines outcome in patients with pulmonary hypertension, congenital heart diseases and in left ventricular failure. In 2006, the Working Group on Cellular and Molecular Mechanisms of Right Heart Failure of the NIH advocated the development of preclinical models to study the pathophysiology and pathobiology of RV failure. In this review, we summarize the progress of research into the pathobiology of RV failure and potential therapeutic interventions. The picture emerging from this research is that RV adaptation to increased afterload is characterized by increased contractility, dilatation and hypertrophy. Clinical RV failure is associated with progressive diastolic deterioration and disturbed ventricular-arterial coupling in the presence of increased contractility. The pathobiology of the failing RV shows similarities with that of the LV and is marked by lack of adequate increase in capillary density leading to a hypoxic environment and oxidative stress and a metabolic switch from fatty acids to glucose utilization. However, RV failure also has characteristic features. So far, therapies aiming to specifically improve RV function have had limited success. The use of beta blockers and sildenafil m...Continue Reading

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Citations

Dec 19, 2016·Experimental Physiology·Mario BoehmBaktybek Kojonazarov
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Jun 20, 2020·Heart Failure Reviews·Yannick J H J TaverneDaphne Merkus
Mar 17, 2021·British Journal of Pharmacology·Joshua P DignamAdrian J Hobbs

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