Forgotten No More: A Focused Update on the Right Ventricle in Cardiovascular Disease

Publication date: Available online 10 October 2018Source: JACC: Heart FailureAuthor(s): Myriam Amsallem, Olaf Mercier, Yukari Kobayashi, Kegan Moneghetti, Francois HaddadAbstractIn the last decade, there has been renewed interest in the study of the right ventricle. It is now well established that right ventricular function is a strong predictor of mortality, not only in heart failure but also in pulmonary hypertension, congenital heart disease, and cardiothoracic surgery. The right ventricle is part of a cardiopulmonary unit with connections to the pulmonary circulation, venous return, atria, and left ventricle. In this context, ventriculoarterial coupling, interventricular interactions, and pericardial constraint become important to understand right ventricular adaptation to injury or abnormal loading conditions. This state-of-the-art review summarizes major advances that occurred in the field of right ventricular research over the last decade. The first section focuses on right ventricular physiology and pulmonary circulation. The second section discusses the emerging data on right ventricular phenotyping, highlighting the importance of myocardial deformation (strain) imaging and assessment of end-systolic dimensions. The third section reviews recent clinical trials involving patients at risk for or with established right ventricular failure, focusing on beta blockade, phosphodiesterase inhibition, and mechanical support of the failing right heart. The final section presen...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research

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Purpose of review To discuss the risk preexisting or new onset cardiomyopathy/heart failure (CMP/heart failure) in pregnant woman, and recent insights regarding their management and therapy. Recent findings Recent data from the European Registry on Pregnancy and Heart disease of the European Society of Cardiology (ROPAC) suggest that, after an adequate prepregnancy evaluation in specialized centres, the vast majority of pregnancies are safe for both mother and foetus. A tailored approach is required according to cardiac phenotype (i.e. type of cardiomyopathy), clinical and functional status, and new potential treatmen...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research
PULMONARY HYPERTENSION (PH) is a major cause of mortality and morbidity in patients undergoing cardiac surgery. In the early days, mitral valve disease was the most common cause of PH in left heart disease,1 and rheumatic fever was the leading cause of valvular heart disease. The scenario has changed, and currently heart failure with preserved ejection fraction and heart failure with systolic dysfunction are the most common causes of PH in left heart disease.1 In developing countries, rheumatic valvular heart disease continues to be a major cause of secondary PH.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
This study aimed to evaluate age at first onset of cardiac complications and variation of frequency of complications between different congenital heart defects.MethodsThe analysis included participants of the Swiss Adult Congenital HEart disease Registry (SACHER). For this study cardiac complications up to the time of inclusion in SACHER were analyzed. Complications included atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, complete heart block, heart failure, stroke, endocarditis, myocardial infarction and pulmonary hypertension. Incidence rates (IR; incidence rate per 1000 patien...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
In conclusion, prolonged AI and/or LS infusions in HF are safe and beneficial even in small infants, allowing stabilization and reasonable social and family life out of the hospital. It may provi de precious time for heart transplantation or myocardial remodeling, improvement, and possible discontinuation even after long periods of support.
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
ConclusionsECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSIONS: ECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation. PMID: 30236527 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Abstract Endothelial-to-mesenchymal transition (EndMT) is a process in which endothelial cells lose their properties and transform into fibroblast-like cells. This transition process contributes to cardiac fibrosis, a common feature of patients with chronic heart failure. To date, no specific therapies to halt or reverse cardiac fibrosis are available, so knowledge of the underlying mechanisms of cardiac fibrosis is urgently needed. In addition, EndMT contributes to other cardiovascular pathologies such as atherosclerosis and pulmonary hypertension, but also to cancer and organ fibrosis. Remarkably, the molecular ...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
Authors: Manolis AA, Manolis TA, Mikhailidis DP, Manolis AS Abstract INTRODUCTION: Cancer patients are subject to cardiotoxic effects of cancer therapy and as more patients survive cancer due to improved treatment they are exposed to various forms of cardiovascular (CV) disease (CVD) as they age, and vice-versa. Such an interplay of age with both malignancy and CVD may contribute to increased morbidity and mortality. Areas covered: This review considers the effects of cancer drug treatment on the CV system. In Part I of this review, the various types of CV and cardiometabolic toxicity of anti-cancer drugs and the p...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
Pulmonary hypertension (PH) due to left heart disease, or WHO group 2 PH, is the most frequent cause of PH. It affects approximately 50% to 60% of patients with heart failure with preserved ejection fraction as well as 60% of those with heart failure with reduced ejection fraction and contributes significantly to disease progression and unfavorable outcomes. The diagnosis of PH is associated with poor prognosis and significant morbidity and mortality.
Source: Heart Failure Clinics - Category: Cardiology Authors: Source Type: research
Purpose of review Right ventricular (RV) assessment has long been challenging and technically difficult using echocardiography. This is mainly the result of the asymmetrical shape of the RV making it difficult to visualize on one-or-two dedicated views, thus requiring multiple integrated views and subjective assessment. Measurement of tricuspid annular systolic plane excursion and RV tissue Doppler velocity have become relied-upon methods of objective assessments; however, have limitations for characterizing true RV physiology. Recent findings Studies suggest that two-dimensional RV free wall longitudinal systolic str...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: IMAGING AND HEART FAILURE: MYOCARDIAL STRAIN: Edited by Sherif Nagueh Source Type: research
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