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Related Experiment Video

Updated: Feb 22, 2026

Author Spotlight: Investigating the Underlying Mechanisms of Right Ventricular Failure in Pulmonary Hypertension
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RV pressure overload: from hypertrophy to failure.

Cathelijne E E van der Bruggen1, Ryan J Tedford2, Martin Louis Handoko3

  • 1Department of Pulmonology, Amsterdam Cardiovascular Sciences, VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.

Cardiovascular Research
|September 29, 2017
PubMed
Summary

Pulmonary arterial hypertension (PAH) involves right ventricular (RV) adaptation to pressure overload. Comparing Eisenmenger syndrome, systemic sclerosis, and idiopathic PAH reveals distinct RV phenotypes, differentiating adaptation from failure.

Keywords:
Eisenmenger syndromePulmonary arterial hypertensionRight ventricleSystemic sclerosis

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Area of Science:

  • Cardiology
  • Pulmonary Hypertension
  • Right Ventricular Function

Background:

  • Pulmonary arterial hypertension (PAH) causes chronic right ventricular (RV) pressure overload.
  • RV adaptation is crucial, but compensatory mechanisms eventually fail, leading to RV failure.
  • The transition from RV adaptation to failure in PAH remains poorly understood.

Purpose of the Study:

  • To investigate RV adaptation processes in PAH by comparing different etiologies.
  • To elucidate the mechanisms differentiating RV adaptation from RV failure.
  • To compare RV phenotypes in PAH secondary to Eisenmenger syndrome, systemic sclerosis, and idiopathic PAH.

Main Methods:

  • Comparative review of RV adaptation and failure phenotypes across distinct PAH etiologies.
  • Analysis of RV hypertrophy, contractility, fibrosis, and diastolic stiffness.
  • Correlation of RV structural and functional characteristics with patient prognosis.

Main Results:

  • RV afterload is similar across studied PAH groups, but prognosis differs significantly.
  • An adaptive RV phenotype (Eisenmenger syndrome) shows hypertrophy, increased contractility, low fibrosis, and low diastolic stiffness.
  • A RV failure phenotype (PAH-systemic sclerosis) exhibits impaired contractile reserve, increased fibrosis, and increased diastolic stiffness.

Conclusions:

  • Comparing PAH etiologies offers insights into RV adaptation and failure mechanisms.
  • Distinct RV phenotypes correlate with specific PAH causes and patient outcomes.
  • Understanding these differences is key to managing RV failure in pulmonary arterial hypertension.