scholarly journals Pulmonary Artery Denervation Significantly Increases 6-Min Walk Distance for Patients With Combined Pre- and Post-Capillary Pulmonary Hypertension Associated With Left Heart Failure

2019 ◽  
Vol 12 (3) ◽  
pp. 274-284 ◽  
Author(s):  
Hang Zhang ◽  
Juan Zhang ◽  
Mengxuan Chen ◽  
Du-Jiang Xie ◽  
Jing Kan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Left Heart ◽  
Walk Distance ◽  
Left Heart Failure

scholarly journals Heart rate variability in severe right or left heart failure: the role of pulmonary hypertension and resistances

2004 ◽  
Vol 6 (2) ◽  
pp. 181-185 ◽  
Author(s):  
Laurent Fauchier ◽  
Dominique Babuty ◽  
Alexandre Melin ◽  
Pierre Bonnet ◽  
Pierre Cosnay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Pulmonary Hypertension ◽  
Heart Rate Variability ◽  
Left Heart ◽  
Left Heart Failure

scholarly journals Hemodynamic Phenotyping of Pulmonary Hypertension in Left Heart Failure

2017 ◽  
Vol 10 (9) ◽  
Author(s):  
Robert Naeije ◽  
Mario Gerges ◽  
Jean-Luc Vachiery ◽  
Sergio Caravita ◽  
Christian Gerges ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Left Heart ◽  
Left Heart Failure

scholarly journals Pulmonary vascular mechanical consequences of ischemic heart failure and implications for right ventricular function

2019 ◽  
Vol 316 (5) ◽  
pp. H1167-H1177 ◽  
Author(s):  
Jennifer L. Philip ◽  
Thomas M. Murphy ◽  
David A. Schreier ◽  
Sydney Stevens ◽  
Diana M. Tabima ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Pulmonary Fibrosis ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Pulmonary Vasculature ◽  
Left Heart ◽  
Left Heart Failure ◽  
Reduced Ejection Fraction ◽  
Pathologic Features

Left heart failure (LHF) is the most common cause of pulmonary hypertension, which confers an increase in morbidity and mortality in this context. Pulmonary vascular resistance has prognostic value in LHF, but otherwise the mechanical consequences of LHF for the pulmonary vasculature and right ventricle (RV) remain unknown. We sought to investigate mechanical mechanisms of pulmonary vascular and RV dysfunction in a rodent model of LHF to address the knowledge gaps in understanding disease pathophysiology. LHF was created using a left anterior descending artery ligation to cause myocardial infarction (MI) in mice. Sham animals underwent thoracotomy alone. Echocardiography demonstrated increased left ventricle (LV) volumes and decreased ejection fraction at 4 wk post-MI that did not normalize by 12 wk post-MI. Elevation of LV diastolic pressure and RV systolic pressure at 12 wk post-MI demonstrated pulmonary hypertension (PH) due to LHF. There was increased pulmonary arterial elastance and pulmonary vascular resistance associated with perivascular fibrosis without other remodeling. There was also RV contractile dysfunction with a 35% decrease in RV end-systolic elastance and 66% decrease in ventricular-vascular coupling. In this model of PH due to LHF with reduced ejection fraction, pulmonary fibrosis contributes to increased RV afterload, and loss of RV contractility contributes to RV dysfunction. These are key pathologic features of human PH secondary to LHF. In the future, novel therapeutic strategies aimed at preventing pulmonary vascular mechanical changes and RV dysfunction in the context of LHF can be tested using this model. NEW & NOTEWORTHY In this study, we investigate the mechanical consequences of left heart failure with reduced ejection fraction for the pulmonary vasculature and right ventricle. Using comprehensive functional analyses of the cardiopulmonary system in vivo and ex vivo, we demonstrate that pulmonary fibrosis contributes to increased RV afterload and loss of RV contractility contributes to RV dysfunction. Thus this model recapitulates key pathologic features of human pulmonary hypertension-left heart failure and offers a robust platform for future investigations.

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