Pathophysiology of Acute and Chronic Right Heart Failure

Rajarajan A Thandavarayan; Kalyan R Chitturi; Ashrith Guha

doi:10.1016/j.ccl.2020.01.009

Pathophysiology of Acute and Chronic Right Heart Failure

Cardiol Clin. 2020 May;38(2):149-160. doi: 10.1016/j.ccl.2020.01.009. Epub 2020 Mar 5.

Authors

Rajarajan A Thandavarayan¹, Kalyan R Chitturi¹, Ashrith Guha²

Affiliations

¹ Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Houston, TX 77030, USA.
² Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Houston, TX 77030, USA. Electronic address: gashrith@houstonmethodist.org.

PMID: 32284093
DOI: 10.1016/j.ccl.2020.01.009

Abstract

Right-sided heart failure (RHF) occurs from impaired contractility of the right ventricle caused by pressure, volume overload, or intrinsic myocardial contractile dysfunction. The development of subclinical right ventricle (RV) dysfunction or overt RHF is a negative prognostic indicator. Recent attention has focused on RV-specific inflammatory growth factors and mediators of myocardial fibrosis to elucidate the mechanisms leading to RHF and potentially guide the development of novel therapeutics. This article focuses on the distinct changes in RV structure, mechanics, and function, as well as molecular and inflammatory mediators involved in the pathophysiology of acute and chronic RHF.

Keywords: Angiogenesis; Hypertrophy; Inflammation; Mechanical circulatory support; Metabolism; Pulmonary hypertension; Right heart failure.

Publication types

Review

MeSH terms

Acute Disease
Disease Progression
Heart Failure / etiology
Heart Failure / physiopathology*
Heart Ventricles / physiopathology*
Humans
Myocardial Contraction / physiology*
Ventricular Dysfunction, Right / complications*
Ventricular Dysfunction, Right / physiopathology
Ventricular Function, Right / physiology*