Review
Medicine, General & Internal
Qing He, Yixia Lin, Ye Zhu, Lang Gao, Mengmeng Ji, Li Zhang, Mingxing Xie, Yuman Li
Summary: Right ventricular-pulmonary artery coupling refers to the relationship between RV contractility and RV afterload. RV-PA uncoupling leads to RV dysfunction and right heart failure. Accurate evaluation of RV-PA coupling is important for patient assessment, clinical decision making, risk stratification, and prognosis judgment in cardiovascular diseases.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Pharmacology & Pharmacy
Argen Mamazhakypov, Lutz Hein, Achim Lother
Summary: Pulmonary hypertension is a devastating condition that causes severe damage to the cardiovascular system. Research has found that aldosterone and the mineralocorticoid receptor play a key role in the development of pulmonary hypertension. Pharmacological blockade of the mineralocorticoid receptor has been shown to reduce pulmonary hypertension and prevent right ventricular failure in experimental models. However, the effectiveness of using mineralocorticoid receptor antagonists in the treatment of pulmonary hypertension is controversial in clinical practice and further research is needed.
PHARMACOLOGY & THERAPEUTICS
(2022)
Review
Medicine, General & Internal
Jixiang Liu, Peiran Yang, Han Tian, Kaiyuan Zhen, Colm McCabe, Lan Zhao, Zhenguo Zhai
Summary: Chronic thromboembolic pulmonary hypertension (CTEPH) is a curable pulmonary vascular disease that is often overlooked. It causes adaptive and maladaptive remodeling of the right ventricle, leading to right heart failure and ultimately death. However, our understanding of the right ventricular remodeling process in CTEPH is currently limited.
JOURNAL OF TRANSLATIONAL INTERNAL MEDICINE
(2022)
Review
Physiology
Danial Sharifi Kia, Kang Kim, Marc A. Simon
Summary: Pulmonary arterial hypertension (PAH) leads to increased right ventricular (RV) afterload and remodeling, with recent biomechanical studies revealing important connections between RV biomechanics and physiological function. The current understanding of RV structure and function in PAH is highlighted, along with recent research on the biomechanics of RV remodeling at various levels. The clinical relevance of RV biomechanics in PAH, as well as gaps in knowledge and future research directions, are also discussed.
FRONTIERS IN PHYSIOLOGY
(2021)
Article
Medicine, General & Internal
Sylwia Slawek-Szmyt, Aleksander Araszkiewicz, Stanislaw Jankiewicz, Marek Grygier, Tatiana Mularek-Kubzdela, Maciej Lesiak
Summary: Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious condition with no reliable risk stratification strategy. This study found that the pulmonary artery pulsatility index (PAPI) is a novel hemodynamic index that can predict the prognosis of inoperable CTEPH patients and may be applicable for risk stratification.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Emilio A. Mendiola, Denielli da Silva Goncalves Bos, Dana M. Leichter, Alexander Vang, Peng Zhang, Owen P. Leary, Richard J. Gilbert, Reza Avazmohammadi, Gaurav Choudhary
Summary: This study investigated the effect of architectural remodeling on right ventricular (RV) adaptation in pulmonary hypertension (PH) using two rodent models. The results showed that in rats with mild RV maladaptation, there was a decrease in fiber orientation helical range in the RV free wall, preserved global circumferential strain, and less reduction in RV-pulmonary arterial coupling. These findings suggest that adaptive RV architectural remodeling could improve RV function in PH.
CIRCULATION-HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Thomas J. Cahill, Philippe Pibarot, Xiao Yu, Vasilis Babaliaros, Philipp Blanke, Marie-Annick Clavel, Pamela S. Douglas, Omar K. Khalique, Jonathon Leipsic, Raj Makkar, Maria C. Alu, Susheel Kodali, Michael J. Mack, Martin B. Leon, Rebecca T. Hahn
Summary: This study aimed to assess the incidence and prognostic significance of impaired RV-PA coupling in high-risk patients with symptomatic severe AS undergoing transcatheter or surgical aortic valve replacement. The findings showed that impaired RV-PA coupling was associated with adverse clinical outcomes.
JACC-CARDIOVASCULAR INTERVENTIONS
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Di Zhou, Xin Li, Gang Yin, Shuang Li, Shihua Zhao, Zhihong Liu, Minjie Lu
Summary: By using cardiac MR feature tracking to assess right ventricular strain in patients with pulmonary hypertension, it is possible to stratify risk, predict prognosis, and provide crucial information on right ventricular remodeling, pulmonary hemodynamic condition, and exercise capacity.
JOURNAL OF MAGNETIC RESONANCE IMAGING
(2023)
Article
Cardiac & Cardiovascular Systems
Xiaoxiao Guo, Jinzhi Lai, Hui Wang, Zhuang Tian, Qian Wang, Jiuliang Zhao, MengTao Li, Quan Fang, Ligang Fang, Yongtai Liu, Xiaofeng Zeng
Summary: The TAPSE/PASP ratio and 6MWD are independent predictors for the endpoint in patients with SLE-associated PAH. Combining assessment of these two factors can help identify a subgroup of patients at high risk for poor prognosis.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2021)
Article
Cardiac & Cardiovascular Systems
Tadakatsu Inagaki, James T. Pearson, Hirotsugu Tsuchimochi, Daryl O. Schwenke, Shigeyoshi Saito, Takahiro Higuchi, Takeshi Masaki, Keiji Umetani, Mikiyasu Shirai, Yoshikazu Nakaoka
Summary: The study found impaired vasodilator responses in the right coronary artery of severe pulmonary hypertension rat models, which could be partially restored by endothelin-1 receptor antagonist treatment. This treatment improved RV function by attenuating right heart afterload and improving right coronary endothelial function, showing potential for preventing heart failure in severe PAH patients.
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY
(2021)
Article
Physiology
Katsiaryna Tsarova, Ashley E. Morgan, Lana Melendres-Groves, Majd M. Ibrahim, Christy L. Ma, Irene Z. Pan, Nathan D. Hatton, Emily M. Beck, Meganne N. Ferrel, Craig H. Selzman, Dominique Ingram, Ayedh K. Alamri, Mark B. Ratcliffe, Brent D. Wilson, John J. Ryan
Summary: The right ventricle and pulmonary arterial tree are closely connected in RV-PA coupling, which involves the transfer of energy. A balance of RV contractility, pulmonary vascular resistance, and compliance is necessary to maintain this relationship. Disease progression can disrupt this balance and lead to harmful consequences. Noninvasive imaging techniques provide insights into coupling status and allow for prognostication and intervention.
COMPREHENSIVE PHYSIOLOGY
(2022)
Review
Medicine, General & Internal
Jean Bonnemain, Zied Ltaief, Lucas Liaudet
Summary: Infection with SARS-CoV2 can lead to COVID-19, with severe cases potentially developing ARDS and cardiac complications, particularly RV dysfunction associated with poor prognosis. The pathophysiological mechanisms involve increased pulmonary vascular load and reduced RV contractility, and therapeutic management includes protective mechanical ventilation, prevention of vasoconstriction and thrombotic complications, and appropriate RV preload and contractility management.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Neurosciences
Masafumi Fukumitsu, Joanne A. Groeneveldt, Natalia J. Braams, Ahmed A. Bayoumy, J. Tim Marcus, Lilian J. Meijboom, Frances S. de Man, Harm-Jan Bogaard, Anton Vonk Noordegraaf, Berend E. Westerhof
Summary: Right ventricular wall tension in pulmonary arterial hypertension is influenced by both pressure and volume. Early return of reflected waves in PAH patients is associated with more severe right ventricular hypertrophy. Treatment of PAH not only reduces pulmonary vascular resistance, but also delays the arrival time of reflected waves.
JOURNAL OF PHYSIOLOGY-LONDON
(2022)
Article
Medicine, General & Internal
Remigiusz Kazimierczyk, Ewelina Kazimierczyk, Malgorzata Knapp, Bozena Sobkowicz, Lukasz A. Malek, Piotr Blaszczak, Katarzyna Ptaszynska-Kopczynska, Ryszard Grzywna, Karol A. Kaminski
Summary: The study showed that the TAPSE/sPAP ratio in patients with pulmonary arterial hypertension (PAH) is a valuable prognostic parameter for assessing hemodynamic adaptation and predicting outcomes, providing an easy and reliable non-invasive tool for comprehensive evaluation of patients' condition.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Neurosciences
Tao Fujioka, Yohei Akazawa, Haruki Ide, Gauri Rani Karur, Badr Bannan, Lars Grosse-Wortmann, Mei Sun, Wei Hui, Cameron Slorach, Osami Honjo, Mark K. Friedberg
Summary: Right ventricular pressure overload leads to dysfunction in both the right ventricle and left ventricle, manifested as hypertrophy, dilatation, and fibrosis. Relief of right ventricular pressure load improves the structure and function of both ventricles, independent of fibrosis. However, the long-term implications of persistent fibrosis and increased filling pressures in both ventricles, even after pressure load relief, require further study.
JOURNAL OF PHYSIOLOGY-LONDON
(2022)
Article
Respiratory System
Marc Humbert, Vallerie McLaughlin, J. Simon R. Gibbs, Mardi Gomberg-Maitland, Marius M. Hoeper, Ioana R. Preston, Rogerio Souza, Aaron B. Waxman, Hossein-Ardeschir Ghofrani, Pilar Escribano Subias, Jeremy Feldman, Gisela Meyer, David Montani, Karen M. Olsson, Solaiappan Manimaran, Janethe de Oliveira Pena, David B. Badesch
Summary: In participants with pulmonary arterial hypertension, 24 weeks of sotatercept resulted in a significant reduction in pulmonary vascular resistance. This study reports the longer-term safety and efficacy of sotatercept in the PULSAR open-label extension, showing that sotatercept has good safety and efficacy in patients with pulmonary arterial hypertension.
EUROPEAN RESPIRATORY JOURNAL
(2023)
Article
Medicine, General & Internal
Leon Genecand, Gaetan Simian, Roberto Desponds, Julie Wacker, Silvia Ulrich, Benoit Lechartier, Jean-Marc Fellrath, Olivier Sitbon, Maurice Beghetti, Frederic Lador
Summary: This study aimed to establish a mathematical model for evaluating the probability of classifying PcPH or unclassified PH by using direct Fick method instead of thermodilution to measure cardiac output. The results showed that this model can help clinicians evaluate the potential benefit of using direct Fick method for measuring cardiac output in the diagnostic work-up and determine its utility in confirming or ruling out a diagnosis of PcPH.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Critical Care Medicine
Phillip Joseph, Inderjit Singh, Rudolf Oliveira, Christine A. Capone, Mary P. Mullen, Dane B. Cook, Mary Catherine Stovall, Johanna Squires, Kristine Madsen, Aaron B. Waxman, David M. Systrom
Summary: This review highlights the exercise pathophysiologic commonalities between PASC and ME/CFS, which can guide future diagnostics and treatment.
Article
Respiratory System
Aaron Waxman, Ricardo Restrepo-Jaramillo, Thenappan Thenappan, Peter Engel, Abubakr Bajwa, Ashwin Ravichandran, Jeremy Feldman, Amy Hajari Case, Rahul G. Argula, Victor Tapson, Peter Smith, Chunqin Deng, Eric Shen, Steven D. Nathan
Summary: This study evaluated the long-term effects of inhaled treprostinil in patients with pulmonary hypertension due to interstitial lung disease. The results support the long-term safety and efficacy of inhaled treprostinil in these patients.
EUROPEAN RESPIRATORY JOURNAL
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Hector O. Ventura, Carl J. Lavie, Mandeep R. Mehra
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Letter
Cardiac & Cardiovascular Systems
John W. Ostrominski, Sara R. Machado, Elias Mossialos, Mandeep R. Mehra, Muthiah Vaduganathan
JACC-HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Akshay S. Desai, Alan Maisel, Mandeep R. Mehra, Michael R. Zile, Anique Ducharme, Sara Paul, Samuel F. Sears, Frank Smart, Kunjan Bhatt, Selim Krim, John Henderson, Nessa Johnson, Philip B. Adamson, Maria Rosa Costanzo, Joann Lindenfeld
Summary: This study assessed the efficacy and safety of hemodynamic-guided heart failure (HF) management in patients with elevated natriuretic peptides (NPs) but no recent HF hospitalization (HFH). The results showed consistent effects of hemodynamic monitoring in both patient groups, supporting the consideration of hemodynamic monitoring in the expanded group of chronic HF patients with elevated NPs.
JACC-HEART FAILURE
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Mandeep R. Mehra, Aditi Nayak, Akshay S. Desai
Summary: Contemporary durable LVAD therapy remains an important approach in the care paradigm for patients with advanced HF. We suggest a strategy to timely recognize disease progression, effectively communicate therapeutic benefits, and enhance life quality and expectancy through timely referral and treatment for these vulnerable patients.
JACC-HEART FAILURE
(2023)
Review
Respiratory System
Sarah Cullivan, Sean Gaine, Olivier Sitbon
Summary: Pulmonary hypertension is a prevalent disease with high morbidity and mortality. Efforts have been made to improve disease recognition, diagnosis, and management, reflected in the updated guidelines. Changes in the definition, risk stratification, and emphasis on comorbidities and phenotyping provide new opportunities for early identification and patient-centered treatment decisions. New treatment pathways and potential targeted therapies are emerging, along with the recognition of the importance of supervised training and interventional therapies. This article highlights the trends in pulmonary hypertension, focusing on the revised guidelines.
EUROPEAN RESPIRATORY REVIEW
(2023)
Letter
Critical Care Medicine
Steven D. Nathan, Aaron B. Waxman
Article
Respiratory System
Rogerio Souza, David B. Badesch, H. Ardeschir Ghofrani, J. Simon R. Gibbs, Mardi Gomberg-Maitland, Vallerie V. Mclaughlin, Ioana R. Preston, Aaron B. Waxman, Ekkehard Gruenig, Grzegorz Kope, Gisela Meyer, Karen M. Olsson, Stephan Rosenkranz, Jianxin Lin, Amy O. Johnson-Levonas, Janethe de Oliveira Pena, Marc Humbert, Marius M. Hoeper
Summary: Sotatercept demonstrated significant improvements in pulmonary artery pressure and right heart function in pre-treated patients with pulmonary arterial hypertension (PAH).
EUROPEAN RESPIRATORY JOURNAL
(2023)
Review
Medicine, General & Internal
Athenais Boucly, Christian Gerges, Laurent Savale, Xavier Jais, Mitja Jevnikar, David Montani, Olivier Sitbon, Marc Humbert
Summary: Pulmonary arterial hypertension (PAH) is a rare and progressive disease that requires a complete work-up for a correct diagnosis. Current treatments target the specific pathways of endothelial dysfunction and the choice of therapy depends on the severity of the condition. Recent advances have led to the development of promising emerging therapies targeting dysfunctional pathways beyond endothelial dysfunction.
Review
Respiratory System
Sabina Solinas, Athenais Boucly, Antoine Beurnier, Mithum Kularatne, Julien Grynblat, Melanie Eyries, Peter Dorfmueller, Olivier Sitbon, Marc Humbert, David Montani
Summary: Pulmonary veno-occlusive disease (PVOD), characterized by substantial involvement of small pulmonary veins and capillaries, is an uncommon etiology of pulmonary arterial hypertension (PAH). Recent advancements include the discovery of biallelic mutations in the EIF2AK4 gene causing heritable PVOD. Differentiating PVOD from PAH is vital due to the worse prognosis and poor response of PVOD to PAH-approved drugs.
EXPERT REVIEW OF RESPIRATORY MEDICINE
(2023)
Letter
Critical Care Medicine
David Montani, Jason Weatherald, Marc Humbert, Olivier Sitbon
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Letter
Respiratory System
Steven D. Nathan, Boris Medarov, Lawrence Ho, John Kingrey, Taekwon Hong, Youlan Rao, Eric Shen, Peter Smith, Chunqin Deng, Aaron Waxman
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2023)
