Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: an update
Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: an update
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DOI：
10.1183/13993003.01900-2018
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发表时间：
2019-01-01
影响因子：
24.3
通讯作者：
Naeije, Robert
中科院分区：
文献类型：
--
作者：
Noordegraaf, Anton Vonk;Chin, Kelly Marie;Naeije, Robert
右心室的功能决定了肺动脉高压患者的命运。由于右心衰是后负荷增加的结果，因此需要对包括右心室和肺血管系统在内的心肺单元进行完整的生理描述才能正确解释临床数据。在这里，我们提供了这样一个单位及其组成部分的描述，包括右心室及其负荷之间的功能相互作用。这种生理描述用于为解释右心导管数据以及超声心动图或磁共振成像获得的右心室成像数据提供框架。最后，对右心室衰竭病理生物学的最新见解进行了更新，包括右心室压力过载的分子适应的关键途径。在此基础上，提出了今后的研究方向。
The function of the right ventricle determines the fate of patients with pulmonary hypertension. Since right heart failure is the consequence of increased afterload, a full physiological description of the cardiopulmonary unit consisting of both the right ventricle and pulmonary vascular system is required to interpret clinical data correctly. Here, we provide such a description of the unit and its components, including the functional interactions between the right ventricle and its load. This physiological description is used to provide a framework for the interpretation of right heart catheterisation data as well as imaging data of the right ventricle obtained by echocardiography or magnetic resonance imaging. Finally, an update is provided on the latest insights in the pathobiology of right ventricular failure, including key pathways of molecular adaptation of the pressure overloaded right ventricle. Based on these outcomes, future directions for research are proposed.