TY - JOUR
T1 - Right ventricular failure
T2 - a comorbidity or a clinical emergency?
AU - Das, Pamelika
AU - Thandavarayan, Rajarajan A.
AU - Watanabe, Kenichi
AU - Velayutham, Ravichandiran
AU - Arumugam, Somasundaram
N1 - Funding Information:
We thankfully acknowledge the support extended by Mr. Manoj L. Yellurkar and Mr. Vani Sai Prasanna in literature collection.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/9
Y1 - 2022/9
N2 - There has been ample data providing a convincing perception about the underlying mechanism pertaining to left ventricle (LV) hypertrophy progressing towards LV failure. In comparison, data available on the feedback of right ventricle (RV) due to volume or pressure overload is minimal. Advanced imaging techniques have aided the study of physiology, anatomy, and diseased state of RV. However, the treatment scenario of right ventricular failure (RVF) demands more attention. It is a critical clinical risk in patients with carcinoid syndrome, pulmonary hypertension, atrial septal defect, and several other concomitant diseases. Although the remodeling responses of both ventricles on an increase of end-diastolic pressure are mostly identical, the stressed RV becomes more prone to oxidative stress activating the apoptotic mechanism with diminished angiogenesis. This instigates the advancement of RV towards failure in contrast to LV. Empirical heart failure (HF) therapies have been ineffective in improving the mortality rate and cardiac function in patients, which prompted a difference between the underlying pathophysiology of RVF and LV failure. Treatment strategies should be devised, taking into consideration the anatomical and physiological characteristics of RV. This review would emphasize on the pathophysiology of the RVF and the differences between two ventricles in molecular response to stress. A proper insight into the underlying pathophysiology is required to develop optimized therapeutic management in RV-specific HF.
AB - There has been ample data providing a convincing perception about the underlying mechanism pertaining to left ventricle (LV) hypertrophy progressing towards LV failure. In comparison, data available on the feedback of right ventricle (RV) due to volume or pressure overload is minimal. Advanced imaging techniques have aided the study of physiology, anatomy, and diseased state of RV. However, the treatment scenario of right ventricular failure (RVF) demands more attention. It is a critical clinical risk in patients with carcinoid syndrome, pulmonary hypertension, atrial septal defect, and several other concomitant diseases. Although the remodeling responses of both ventricles on an increase of end-diastolic pressure are mostly identical, the stressed RV becomes more prone to oxidative stress activating the apoptotic mechanism with diminished angiogenesis. This instigates the advancement of RV towards failure in contrast to LV. Empirical heart failure (HF) therapies have been ineffective in improving the mortality rate and cardiac function in patients, which prompted a difference between the underlying pathophysiology of RVF and LV failure. Treatment strategies should be devised, taking into consideration the anatomical and physiological characteristics of RV. This review would emphasize on the pathophysiology of the RVF and the differences between two ventricles in molecular response to stress. A proper insight into the underlying pathophysiology is required to develop optimized therapeutic management in RV-specific HF.
KW - Cor pulmonale
KW - Pathophysiology
KW - Right ventricular failure
KW - Treatment
KW - Diastole
KW - Comorbidity
KW - Ventricular Dysfunction, Right
KW - Humans
KW - Heart Failure/complications
KW - Hypertension, Pulmonary
KW - Heart Ventricles/diagnostic imaging
KW - Ventricular Function, Right
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U2 - 10.1007/s10741-021-10192-9
DO - 10.1007/s10741-021-10192-9
M3 - Review article
C2 - 34826024
AN - SCOPUS:85120005406
SN - 1382-4147
VL - 27
SP - 1779
EP - 1793
JO - Heart Failure Reviews
JF - Heart Failure Reviews
IS - 5
ER -