Medical Therapy for Heart Failure Associated With Pulmonary Hypertension
| Autor: | Lisa Mielniczuk, Jason G.E. Zelt, Duncan J. Stewart, Ketul R Chaudhary, Virgilio J. J. Cadete |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Physiology Hypertension Pulmonary Ventricular Dysfunction Right 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Heart Failure Ventricular Remodeling medicine.diagnostic_test business.industry Hemodynamics Cardiovascular Agents Magnetic resonance imaging medicine.disease Pulmonary hypertension Treatment Outcome 030228 respiratory system Heart failure Disease Progression Ventricular Function Right Cardiology Cardiology and Cardiovascular Medicine business Medical therapy Stem Cell Transplantation |
| Zdroj: | Circulation Research. 124:1551-1567 |
| ISSN: | 1524-4571 0009-7330 |
| DOI: | 10.1161/circresaha.118.313650 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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