Mechanisms of Right Heart Failure—A Work in Progress and a Plea for Failure Prevention

PVRI Member Authors: Norbert Voelkel, Harm Jan Bogaard


The right ventricle (RV) of the heart, which pumps blood through a low pressure, low resistance “lesser” circulation, is now receiving more attention by researchers and clinicians, after many years of benign neglect.[17] Some of the many reasons for neglecting the RV assumed that (1) In the context of global cardiac performance, the RV was not very important;[2] and (2) The cellular and molecular mechanisms of RV failure (RVF) were not different from those responsible for LV failure. Perhaps the biggest knowledge gap originated from the lack of experimental studies modeling the development of RVF, and from attempts to extrapolate mechanisms of chronic RVF from studies originally designed to study acute RVF. These likely explain why “pressure overload” is the most frequent—and sometimes exclusively—quoted mechanism of RVF. Indeed, patients with chronic, progressive pulmonary vascular disease most frequently die of RV failure.[8,9]However, as we enlarge our knowledge of in the pathobiology of RVF, we should also begin to consider RVF as a “progressive,” but not necessarily “chronic,” phenomenon.

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Right Heart Failure
Right Ventricle: Structure, Function and Dysfunction


Norbert F. Voelkel, Jose Gomez-Arroyo, Antonio Abbate, Harm J. Bogaard

Published in:

Pulmonary Circulation Vol 3: No 1 cover image

March 2013

Pulmonary Circulation Vol 3: No 1

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