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Zebrafish Brain Ventricle Injection
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The right treatment for the right ventricle
Joanne A Groeneveldt1, Frances S de Man1, Berend E Westerhof1,2
1Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam.
Current Opinion in Pulmonary Medicine
|August 1, 2019
Summary
Right ventricular (RV) failure impacts survival in pulmonary arterial hypertension (PAH). While RV therapies are lacking, new clinical trials explore novel strategies targeting RV wall tension and inflammation.
Area of Science:
- Cardiology
- Pulmonary Hypertension Research
- Translational Medicine
Background:
- Right ventricular (RV) function is critical in pulmonary arterial hypertension (PAH) prognosis.
- RV failure pathogenesis involves increased afterload, wall tension, autonomic imbalance, metabolic shifts, and inflammation.
- Existing treatments for PAH primarily focus on afterload reduction, with limited RV-selective therapies.
Purpose of the Study:
- To review the current treatment landscape for RV failure in PAH.
- To discuss emerging therapeutic strategies for RV failure currently under investigation.
- To highlight the need for RV-selective treatments in PAH management.
Main Methods:
- Review of current literature on RV failure in PAH.
- Analysis of pathobiological mechanisms contributing to RV dysfunction.
- Examination of ongoing clinical trials for novel RV therapies.
Main Results:
- Increased RV afterload leads to elevated wall tension, impairing RV contractility.
- RV failure activates the renin-angiotensin aldosterone system, causing fluid retention and worsening RV tension.
- Several RV-selective drugs targeting determinants of RV wall tension are in clinical trials.
Conclusions:
- Afterload reduction remains central to PAH treatment.
- Novel therapeutic strategies directly targeting RV pathobiology are emerging.
- Clinical trials are investigating promising RV-selective treatments for PAH.
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