Abstract:
:The past 2 decades have witnessed a >40% improvement in mortality for patients with heart failure and left ventricular systolic dysfunction. 1 This success has coincided with the stepwise availability of drugs that target neurohormonal activation: β-adrenergic receptor blockers (β-blockers), ACE (angiotensin-converting enzyme) inhibitors and ANG (angiotensin) II blockers, neprilysin inhibitors, and aldosterone antagonists. Our understanding of right heart failure (RHF) has lagged behind and many proven targeted therapies for left heart failure do not appear to provide similar benefits for RHF. Until recently, the right ventricle (RV) has often been viewed as less important than the left ventricle and in contemporary literature received the moniker "The Forgotten Ventricle". Recent advances in echocardiography and magnetic resonance imaging have enabled detailed assessments of RV anatomy and physiology in both health and disease allowing us to more accurately describe the clinical sequelae and end-organ manifestations of RHF. RV function is now recognized as one of the most important predictors of prognosis in many cardiovascular disease states. 2 Despite the significance of RV function to survival, there are no clinically approved therapies that directly nor selectively improve RV function. As well, relative to our understanding of left heart failure, the basis for RHF remains poorly understood. This article aims to condense the current knowledge on RV adaptation and failure, review current management strategies for RHF, and explore evolving therapeutic approaches.
journal_name
Circ Resjournal_title
Circulation researchauthors
Zelt JGE,Chaudhary KR,Cadete VJ,Mielniczuk LM,Stewart DJdoi
10.1161/CIRCRESAHA.118.313650subject
Has Abstractpub_date
2019-05-24 00:00:00pages
1551-1567issue
11eissn
0009-7330issn
1524-4571journal_volume
124pub_type
杂志文章,评审abstract::The purpose of this study was to determine whether a quantitative relationship existed between a reduction in regional myocardial blood flow, measured by radiolabeled microspheres, and the degree and type of changes in myocardial activation recorded in bipolar left ventricular subepicardial and subendocardial electrog...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.45.6.764
更新日期:1979-12-01 00:00:00
abstract::The kinetic attributes of the afferent arteriole myogenic response were investigated using the in vitro perfused hydronephrotic rat kidney. Equations describing the time course for pressure-dependent vasoconstriction and vasodilation, and steady-state changes in diameter were combined to develop a mathematical model o...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.0000024262.11534.18
更新日期:2002-06-28 00:00:00
abstract::Fibrinopeptide A (FPA) levels were measured in a group of 130 controls and patients with various types of primary hyperlipidemia to investigate whether an increased steady state level of thrombin activity is present in hyperlipidemic patients. In a subset of 56 subjects, levels of clotting factors II, VII, and X were ...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.45.3.347
更新日期:1979-09-01 00:00:00
abstract::Stimulation of beta-adrenergic receptors (betaARs) causes apoptosis in adult rat ventricular myocytes (ARVMs). The role of reactive oxygen species (ROS) in mediating betaAR-stimulated apoptosis is not known. Stimulation of betaARs with norepinephrine (10 micromol/L) in the presence of prazosin (100 nmol/L) for 24 hour...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.0000054624.03539.b4
更新日期:2003-02-07 00:00:00
abstract::Multiple voltage-gated K+ channels contribute to the repolarization phases of the cardiac action potential and are targets of several antiarrhythmic drugs. The Kv1.5 K+ channel gene is expressed in the heart, and heterologous expression of this gene generates a slowly inactivating K+ current. Previously, we found that...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.75.6.1006
更新日期:1994-12-01 00:00:00
abstract:RATIONALE:Hydrogen peroxide (H(2)O(2)) serves as a key endothelium-derived hyperpolarizing factor mediating flow-induced dilation in human coronary arterioles (HCAs). The precise mechanisms by which H(2)O(2) elicits smooth muscle hyperpolarization are not well understood. An important mode of action of H(2)O(2) involve...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/CIRCRESAHA.111.258871
更新日期:2012-02-03 00:00:00
abstract::Tropomyosin (TM) is an integral component of the thin filament in muscle fibers and is involved in regulating actin-myosin interactions. TM is encoded by a family of four alternatively spliced genes that display highly conserved nucleotide and amino acid sequences. To assess the functional and developmental significan...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.82.1.116
更新日期:1998-01-09 00:00:00
abstract::Epidermal fatty acid-binding protein (E-FABP), previously characterized in human keratinocytes, is a cytoplasmic protein of 15 kD that specifically binds fatty acids (FAs). Previous PAGE-immunoblotting studies indicated that several human tissues display an immunoreactive band with an electrophoretic mobility identica...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.81.3.297
更新日期:1997-09-01 00:00:00
abstract::We determined whether local bradykinin production modulates cardiac adrenergic activity. Depolarization of guinea pig heart sympathetic nerve endings (synaptosomes) with 1 to 100 mmol/L K+ caused the release of endogenous norepinephrine (10% to 50% above basal level). This release was exocytotic, because it depended o...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.81.5.774
更新日期:1997-11-01 00:00:00
abstract::Morphogenesis and developmental remodeling of cardiovascular tissues involve coordinated regulation of cell proliferation and apoptosis. In the heart, clear evidence points toward focal apoptosis as a contributor to development of the embryonic outflow tract, cardiac valves, conducting system, and the developing coron...
journal_title:Circulation research
pub_type: 杂志文章,评审
doi:10.1161/01.res.87.10.856
更新日期:2000-11-10 00:00:00
abstract::A period of prolonged vasodilation follows flow-restricted exercise of skeletal muscle. We tested the hypothesis that adenosine participates in mediating this vascular response. Vascularly isolated, anterior calf muscles of anesthetized dogs were stimulated to contract at a rate of 4 twitches/sec. Blood flow was held ...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.44.6.759
更新日期:1979-06-01 00:00:00
abstract::Electrotonic coupling of cardiac myocytes at gap junctions may influence patterns of conduction in myocardium. To delineate the three-dimensional structure and distribution of intercellular junctions, we analyzed serial ultrathin sections of canine myocardium with transmission electron microscopy and disaggregated myo...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.64.3.563
更新日期:1989-03-01 00:00:00
abstract:RATIONALE:Pulmonary arterial hypertension (PAH) remains a progressive and eventually lethal disease characterized by increased pulmonary vascular resistance because of loss of functional lung microvasculature, primarily at the distal (intracinar) arteriolar level. Cell-based therapies offer the potential to repair and ...
journal_title:Circulation research
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCRESAHA.114.305951
更新日期:2015-09-11 00:00:00
abstract::Animal and preliminary human studies of adult cell therapy following acute myocardial infarction have shown an overall improvement of cardiac function. Myocardial and vascular regeneration have been initially proposed as mechanisms of stem cell action. However, in many cases, the frequency of stem cell engraftment and...
journal_title:Circulation research
pub_type: 杂志文章,评审
doi:10.1161/CIRCRESAHA.108.176826
更新日期:2008-11-21 00:00:00
abstract:RATIONALE:The high morbidity/mortality of atherosclerosis is typically precipitated by plaque rupture and consequent thrombosis. However, research on underlying mechanisms and therapeutic approaches is limited by the lack of animal models that reproduce plaque instability observed in humans. OBJECTIVE:Development and ...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/CIRCRESAHA.113.301562
更新日期:2013-07-19 00:00:00
abstract::Three models of altered autonomic innervation of the chick heart have been developed in the last few years. These include sympathetically aneural heart, parasympathetically aneural heart, and heart with cholinergic innervation reconstituted from the nodose placodes. The neural status of these hearts has been assessed ...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.65.6.1547
更新日期:1989-12-01 00:00:00
abstract::The purpose of these experiments was to determine whether or not acetylcholine modulated the electrophysiological effects of isoproterenol on canine cardiac Purkinje fibers. Conventional microelectrode techniques were used. Predictably, isoproterenol produced shortening of action potential duration; acetylcholine sign...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.44.3.378
更新日期:1979-03-01 00:00:00
abstract::AR-L 115BS, a benzimidazole derivative, is a positive inotropic agent that has been shown to increase active tension development and unloaded shortening velocity of chemically skinned heart muscle preparations at submaximal activating levels of free Ca++. We measured the effect of AR-L on relations between free Ca++, ...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.51.3.290
更新日期:1982-09-01 00:00:00
abstract::Nitric oxide (NO) functions principally as a diffusible paracrine effector. The exception is in cardiomyocytes where both NO synthases (NOS) and target proteins coexist, allowing NO to work in an autocrine/intracrine fashion. However, the most abundant myocyte isoform (NOS3) is far more expressed in vascular endotheli...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.RES.0000119323.79644.20
更新日期:2004-03-19 00:00:00
abstract::Protein kinase A (PKA)-mediated enhancement of L-type calcium currents (I(Ca,L)) is essential for sympathetic regulation of the heartbeat and is the classic example of channel regulation by phosphorylation, and its loss is a common hallmark of heart failure. Mechanistic understanding of how distinct Ca(V) channel subu...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/CIRCRESAHA.108.171736
更新日期:2008-04-11 00:00:00
abstract::A number of neurotransmitters modulate cardiac dihydropyridine-sensitive L-type Ca2+ channels through several homologous G protein-coupled receptors. Previous studies that have examined receptor-Ca2+ channel interactions have suffered because of the coexpression of various receptor subtypes in native cells. To study t...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.76.3.335
更新日期:1995-03-01 00:00:00
abstract::Fractalkine, a chemokine expressed by inflamed endothelium, induces leukocyte adhesion and migration via the receptor CX3CR1, and the CX3CR1 polymorphism V249I affects receptor expression and function. Here we show that this polymorphism is an independent risk factor for atherosclerotic coronary artery disease (CAD). ...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/hh1701.095642
更新日期:2001-08-31 00:00:00
abstract::To isolate specific markers of both differentiated and proliferating vascular smooth muscle cells (VSMCs), we used the technique of differential cDNA screening using RNA from cultured rat aortic VSMCs. The tissue specificity of expression of all of the cDNAs isolated was determined by Northern analysis. We isolated se...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.73.1.193
更新日期:1993-07-01 00:00:00
abstract::Increasing evidence suggests that endogenous NO inhibits sympathetic outflow in anesthetized animals. However, in a recent study from this laboratory, we were unable to find any evidence of increased renal sympathetic nerve activity (RSNA) in response to blockade of NO synthesis in conscious rabbits. Because angiotens...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.82.4.496
更新日期:1998-03-09 00:00:00
abstract::The sarcolemmal Na+-Ca2+ exchanger (NCX) is the main Ca2+ extrusion mechanism in cardiac myocytes and is thus essential for the regulation of Ca2+ homeostasis and contractile function. A cytosolic region (f-loop) of the protein mediates regulation of NCX function by intracellular factors including inhibition by exchan...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.RES.0000151334.48676.68
更新日期:2005-01-07 00:00:00
abstract::alpha-Adrenergic receptor stimulation regulates the activity of a number of different cardiac ion channels, including those underlying one or more distinct Cl- conductances. The whole-cell patch-clamp technique was used in the present study to investigate the effects of alpha-adrenergic stimulation on the beta-adrener...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.78.6.1090
更新日期:1996-06-01 00:00:00
abstract::Available data demonstrate that oxygen free radicals and derived reactive species of oxygen are produced during myocardial ischemia as well as upon reperfusion of the ischemic tissue. The present study was designed to determine if polyethylene glycol-conjugated superoxide dismutase (PEG-SOD), with its extended plasma ...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.64.4.665
更新日期:1989-04-01 00:00:00
abstract::An affinity gel for the purification of renin was prepared by coupling pepstatin to aminohexylagarose gel. Partially purified human renin (Haas et al., Arch. Biochem. Biophys., 110, 534-543, 1965) was purified further by affinity chromatography on the pepstatin-aminohexyl-agarose gel, gel filtration on a Sephadex G-75...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.41.4.4
更新日期:1977-10-01 00:00:00
abstract::We evaluated the contribution of intramural electrical events in initiation and maintenance of ventricular tachycardia in 15 dogs 3-8 days after either permanent (n = 2) or transient (n = 13) coronary artery occlusion. Seven of the dogs (47%) demonstrated eight distinct monomorphic ventricular tachycardia patterns whi...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.56.5.736
更新日期:1985-05-01 00:00:00
abstract:RATIONALE:Transcatheter, intramyocardial injections of bone marrow-derived cell therapy produces reverse remodeling in large animal models of ischemic cardiomyopathy. OBJECTIVE:We used cardiac MRI (CMR) in patients with left ventricular (LV) dysfunction related to remote myocardial infarction (MI) to test the hypothes...
journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/CIRCRESAHA.111.242610
更新日期:2011-04-01 00:00:00