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Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension

Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed, but potentially curable pulmonary vascular disease. The increased pulmonary vascular resistance in CTEPH is caused by unresolved proximal thrombus and secondary microvasculopathy in the pulmonary vasculature, leading to adap...

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Autores principales: Liu, Jixiang, Yang, Peiran, Tian, Han, Zhen, Kaiyuan, McCabe, Colm, Zhao, Lan, Zhai, Zhenguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9328037/
https://www.ncbi.nlm.nih.gov/pubmed/35959451
http://dx.doi.org/10.2478/jtim-2022-0027
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author Liu, Jixiang
Yang, Peiran
Tian, Han
Zhen, Kaiyuan
McCabe, Colm
Zhao, Lan
Zhai, Zhenguo
author_facet Liu, Jixiang
Yang, Peiran
Tian, Han
Zhen, Kaiyuan
McCabe, Colm
Zhao, Lan
Zhai, Zhenguo
author_sort Liu, Jixiang
collection PubMed
description Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed, but potentially curable pulmonary vascular disease. The increased pulmonary vascular resistance in CTEPH is caused by unresolved proximal thrombus and secondary microvasculopathy in the pulmonary vasculature, leading to adaptive and maladaptive remodeling of the right ventricle (RV), eventual right heart failure, and death. Knowledge on the RV remodeling process in CTEPH is limited. The progression to RV failure in CTEPH is a markedly slower process. A detailed understanding of the pathophysiology and underlying mechanisms of RV remodeling may facilitate early diagnosis and the development of targeted therapy. While ultrasound, magnetic resonance imaging, right heart catheterization, and serum biomarkers have been used to assess cardiac function, the current treatment strategies reduce the afterload of the right heart, but are less effective in improving the maladaptive remodeling of the right heart. This review systematically summarizes the current knowledge on adaptive and maladaptive remodeling of the right heart in CTEPH from molecular mechanisms to clinical practice.
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spelling pubmed-93280372022-08-10 Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension Liu, Jixiang Yang, Peiran Tian, Han Zhen, Kaiyuan McCabe, Colm Zhao, Lan Zhai, Zhenguo J Transl Int Med Review Article Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed, but potentially curable pulmonary vascular disease. The increased pulmonary vascular resistance in CTEPH is caused by unresolved proximal thrombus and secondary microvasculopathy in the pulmonary vasculature, leading to adaptive and maladaptive remodeling of the right ventricle (RV), eventual right heart failure, and death. Knowledge on the RV remodeling process in CTEPH is limited. The progression to RV failure in CTEPH is a markedly slower process. A detailed understanding of the pathophysiology and underlying mechanisms of RV remodeling may facilitate early diagnosis and the development of targeted therapy. While ultrasound, magnetic resonance imaging, right heart catheterization, and serum biomarkers have been used to assess cardiac function, the current treatment strategies reduce the afterload of the right heart, but are less effective in improving the maladaptive remodeling of the right heart. This review systematically summarizes the current knowledge on adaptive and maladaptive remodeling of the right heart in CTEPH from molecular mechanisms to clinical practice. Sciendo 2022-07-02 /pmc/articles/PMC9328037/ /pubmed/35959451 http://dx.doi.org/10.2478/jtim-2022-0027 Text en © 2022 Jixiang Liu, Peiran Yang, Han Tian, Kaiyuan Zhen, Colm McCabe, Lan Zhao, Zhenguo Zhai, published by Sciendo https://creativecommons.org/licenses/by-nc-nd/3.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
spellingShingle Review Article
Liu, Jixiang
Yang, Peiran
Tian, Han
Zhen, Kaiyuan
McCabe, Colm
Zhao, Lan
Zhai, Zhenguo
Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension
title Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension
title_full Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension
title_fullStr Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension
title_full_unstemmed Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension
title_short Right Ventricle Remodeling in Chronic Thromboembolic Pulmonary Hypertension
title_sort right ventricle remodeling in chronic thromboembolic pulmonary hypertension
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9328037/
https://www.ncbi.nlm.nih.gov/pubmed/35959451
http://dx.doi.org/10.2478/jtim-2022-0027
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