Skip to main content
SpringerLink
Log in

Aging and Right Ventricular Failure from Pulmonary Hypertension: Effect of Right Ventricular and Pulmonary Artery Remodeling

  • Chapter
  • First Online:
Aging and Heart Failure

  • 1717 Accesses

Abstract

Prevalence of pulmonary hypertension (PHTN) is high in the community, affecting 10–20 % of the population and is even higher in elderly patients with left heart failure and chronic lung disease and obese patients with metabolic syndrome. Evidence indicates that aging alters the pulmonary vascular tree histology, right ventricular structure, and hemodynamics in the pulmonary circulation. There is not much research exploring mechanisms of how aging leads to right ventricular and pulmonary vascular remodeling. Although primary PHTN is rare, it is a better studied subset of PHTN and the mechanisms of that disease are better understood. Right ventricular remodeling and right heart failure (RHF) are crucial in determining clinical outcomes in primary PHTN, and similar findings are emerging in other types of PHTN, especially PHTN associated with left heart failure. Much more studies are needed to elucidate the clinical significance of right ventricular remodeling and failure in relation to aging and to define whether this could be a therapeutic target for improving outcomes of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Galie N, Hoeper MM, Humbert M, et al. Guidelines for the diagnosis and treatment of pulmonary arterial hypertension: the Task Force for the Diagnosis and Treatment of pulmonary hypertension of the European Society of Cardiology and the European Respiratory Society, endorsed by the International Society of Heart and Lung Transplantation. Eur Heart J. 2009;30:2493–537.

    PubMed  Google Scholar 

  2. Humbert M, Sitbon O, Chaouat A, et al. Pulmonary arterial hypertension in France: results from a national registry. Am J Respir Crit Care Med. 2006;173(9):1023–30.

    PubMed  Google Scholar 

  3. Shah S. Pulmonary hypertension. JAMA. 2012;308(13):1366–74.

    CAS  PubMed  Google Scholar 

  4. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA. 2010;303(20):2043.

    CAS  PubMed  Google Scholar 

  5. Galie N, Torbicki A, Barst R, et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. ESC task force on diagnosis and treatment of pulmonary arterial hypertension. Eur Heart J. 2004;25:2243–78.

    PubMed  Google Scholar 

  6. Kovacs G, Berghold A, Scheidl S, Olschewski H. Pulmonary arterial pressure during rest and exercise in healthy subjects: a systematic review. Eur Respir J. 2012;39:319–28.

    CAS  PubMed  Google Scholar 

  7. Tolle JJ, Waxman AB, Van Horn TL, Pappagianopoulos PP, et al. Exercise induced pulmonary arterial hypertension. Circulation. 2008;118:2183–9.

    PubMed Central  PubMed  Google Scholar 

  8. Simonneaur G, Robbins IM, Beghetti M, Channick RN, et al. Updated Clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S43.

    Google Scholar 

  9. Mackay EH, Banks J, Sykes B. Structural basis for the changing physical properties of human pulmonary vessels with age. Thorax. 1978;33:335–44.

    CAS  PubMed  Google Scholar 

  10. Lam CS, Borlaug BA, Kane GC, Enders FT, Rodeheffer RJ, Redfield MM. Age associated increases in pulmonary systolic pressure in the general population. Circulation. 2009;119:2663–70.

    PubMed Central  PubMed  Google Scholar 

  11. Peter S. Age related dilatation of the right ventricle in arrhythmogenic right ventricular dysplasia-cardiomyopathy. Int J Cardiol. 1996;56(2):163–7.

    Google Scholar 

  12. Davidson Jr WR, Fee FC. Influence of aging on pulmonary hemodynamics in a population free of coronary artery disease. Am J Cardiol. 1990;65:1454–8.

    PubMed  Google Scholar 

  13. Dalal D, Nari K, Bomma C, et al. Arrhythmogenic right ventricular dysplasia: a United States experience. Circulation. 2005;112:3823.

    PubMed  Google Scholar 

  14. Puwanant S, Park M, Popovic ZB, Tang WH, Farha S, George D, Sharp J, Puntawangkoon J, Loyd JE, Erzurum SC, Thomas JD. Ventricular geometry, strain, and rotational mechanics in pulmonary hypertension. Circulation. 2010;121:259–66.

    PubMed Central  PubMed  Google Scholar 

  15. D’Alanzo GE, Barst RJ, Ayres SM, Bergofsky EH. Survival in patients with primary pulmonary hypertension: results from a national prospective registry. Ann Intern Med. 1991;115:343–9.

    Google Scholar 

  16. Right Heart Failure Summit 2012, Boston, MA, 12–13 October 2012. Program. http://www.medfound.com/rhfs/index.html. Accessed 28 Dec 2013.

  17. Voelkel NF, Quaife RA, Leinwand LA, Gail DB, et al. Right ventricular function and failure, report of a National Heart, Lung, and Blood Institute Working Group on cellular and molecular mechanisms of right heart failure. Circulation. 2006;114:1883–91.

    PubMed  Google Scholar 

  18. Hoeper MM, Markevych I, Spiekerkoetter E, et al. Goal oriented treatment and combination therapy for pulmonary arterial hypertension. Eur Respir J. 2005;26:858–63.

    CAS  PubMed  Google Scholar 

  19. Stibon O, Humbert M, Nunes H, et al. Long term intravenous epoprostenol infusion in primary pulmonary hypertension: prognostic factors and survival. J Am Coll Cardiol. 2002;40:780–8.

    Google Scholar 

  20. Zaffran S, Kelly RG, Meihac SM, Brown NA. Right ventricular myocardium derives from anterior heart field. Circ Res. 2004;95:261–8.

    CAS  PubMed  Google Scholar 

  21. Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European society of cardiology, and the Canadian society of echocardiography. J Am Soc Echocardiogr. 2010;23:685–713.

    PubMed  Google Scholar 

  22. Hess DS, Bache RJ. Transmural right ventricular myocardial blood flow during systole in the awake dog. Circ Res. 1979;45:88–94.

    CAS  PubMed  Google Scholar 

  23. Forman MB, Wilson BH, Sheller JR, et al. Right ventricular hypertrophy is an important determinant of right ventricular infarction complicating acute inferior left ventricular infarction. J Am Coll Cardiol. 1987;10:1180–7.

    CAS  PubMed  Google Scholar 

  24. Kind T, Mauritz GJ, Marcus JT, Vonk-Noordegraaf A. Right ventricular ejection fraction is better reflected by transverse rather than longitudinal wall motion in pulmonary hypertension. J Cardiovasc Magn Reson. 2010;12:35.

    PubMed  Google Scholar 

  25. Brutsaert DL. Cardiac endothelial-myocardial signaling: its role in cardiac growth, contractile performance and rhythmicity. Physiol Rev. 2003;83:59–115.

    CAS  PubMed  Google Scholar 

  26. Sandoval J, Baurle O, Palomar A, Gómez A, Martinez-Guerra ML, Beltran M, et al. Survival in primary pulmonary hypertension: validation of a prognostic equation. Circulation. 1994;89:1733–44.

    CAS  PubMed  Google Scholar 

  27. Mclaughlin VV, Sitbon O, Badesch DB, Barst RJ, et al. Survival with first-line bosentan in patients with primary pulmonary hypertension. Eur Respir J. 2005;25:24–249.

    Google Scholar 

  28. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease. Part I: Anatomy, physiology, aging and functional assessment of the right ventricle. Circulation. 2008;117:1436–48. Part II. 117:1717–31.

    PubMed  Google Scholar 

  29. Phuynh T, Kleerup E, et al. Prognostic factors and outcomes of patients with pulmonary hypertension admitted to the intensive care unit. J Crit Care. 2012;27(6):739e7–13.

    Google Scholar 

  30. Kovacs G, Berghod A, Scheidl S, et al. Pulmonary arterial pressure during rest and exercise in healthy subjects: a systemic review. Eur Respir J. 2009;34(4):888–94.

    CAS  PubMed  Google Scholar 

  31. Hosoda Y, Kawato K, Yamasawa F, Ishii T, et al. Age-dependent changes of collagen and elastin content in human aorta and pulmonary artery. Angiology. 1984;35:615–21.

    CAS  PubMed  Google Scholar 

  32. Ehrsam RE, Perruchoud A, et al. Influence of age on pulmonary haemodynamics at rest and during supine exercise. Clin Sci (Lond). 1983;65:653–60.

    CAS  Google Scholar 

  33. Ghali JK, Liao Y, Cooper RS, et al. Changes in pulmonary hemodynamics with ageing in a predominantly hypertensive population. Am J Cardiol. 1992;70:367–70.

    CAS  PubMed  Google Scholar 

  34. Benza RL, Gomber-Maitland M, Miller DP, et al. The REVEAL Registry risk score calculator in patients with newly diagnosed pulmonary arterial hypertension. Chest. 2012;141:354.

    PubMed  Google Scholar 

  35. Arora R. Pathophysiological basis of RV remodeling. J Cardiovasc Pharmacol Ther. 2007;12(1):5–14.

    PubMed  Google Scholar 

  36. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease. Part II: Anatomy, physiology, aging and functional assessment of the right ventricle. Circulation. 2008;117:1717–31.

    PubMed  Google Scholar 

  37. Vandenheuvel MA, Bouchez S, Wouters PF, De Hert SG. A pathophysiological approach towards right ventricular function and failure. Non-commissioned, conventional narrative review. Eur J Anaesthesiol. 2013;30:1–9.

    Google Scholar 

  38. Kawut S, Marr R, Lima J, David A, et al. Right ventricular structure is associated with the risk of heart failure and cardiovascular death: multi-ethnic study of atherosclerosis (MESA)-right ventricle study. Circulation. 2012;126(14):1681–8.

    PubMed Central  PubMed  Google Scholar 

  39. Stuart R. Pulmonary hypertension. In: Bonow RO, Mann DL, Zipes DP, Libby P, editors. Braunwald’s heart disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012. p. 1696–718.

    Google Scholar 

  40. Humbert M, Morrell NW, Archer SL, et al. Cellular and molecular pathobiology of pulmonary arterial hypertension. J Am Coll Cardiol. 2004;43:13S–24.

    CAS  PubMed  Google Scholar 

  41. Morrell NW, Adnot S, Archer SL, et al. Cellular and molecular basis of pulmonary arterial hypertension. J Am Coll Cardiol. 2009;54:S20.

    CAS  PubMed Central  PubMed  Google Scholar 

  42. Archer SL, Weir EK, Wilkins MR. Basic science of pulmonary arterial hypertension for clinicians. New concepts and experimental therapies. Circulation. 2010;121:2045–66.

    PubMed Central  PubMed  Google Scholar 

  43. Yang J, Davies RJ, Southwood M, Long L, et al. Mutation in bone morphogenetic Protein type II receptor cause dysregulation of Id gene expression in pulmonary artery smooth cells: implications for familial pulmonary hypertension. Circ Res. 2008;102:1212–21.

    CAS  PubMed  Google Scholar 

  44. Herve P, Launay JM, Scrobohaci ML, Brenot F, Simonneau G, et al. Increased plasma serotonin in primary pulmonary hypertension. Am J Med. 1995;99:249–54.

    CAS  PubMed  Google Scholar 

  45. Stewart DJ, Levy RD, Cernacek P, et al. Increased plasma endothelin-1 in pulmonary hypertension: marker or mediator of disease? Ann Intern Med. 1991;114:464–9.

    CAS  PubMed  Google Scholar 

  46. Sakao S, Taraseviciene-Stewart L, Lee JD, Wood K, Cool CD, Voelkel NF. Initial apoptosis is followed by increased proliferation of apoptotic-resistant endothelial cells. FASEB J. 2005;19:1178–80.

    CAS  PubMed  Google Scholar 

  47. Schermjuly RT, Dony E, Ghograni HA, Pullamsetti S, Savai R, et al. Reversal of experimental pulmonary hypertension by PDGF inhibition. J Clin Invest. 2005;115:2811–21.

    Google Scholar 

  48. McMurtry MS, Archer SL, Altieri DC, Bonnet S, Michelakis ED, et al. Gene therapy targeting surviving selectively induces pulmonary vascular apoptosis and reverse pulmonary arterial hypertension. J Clin Invest. 2005;115:1479–91.

    CAS  PubMed Central  PubMed  Google Scholar 

  49. Cowan KN, Jones PL, Rabinovitch M. Elastase and matrix metalloproteinase inhibitors induce regression, and tenascin-c antisense prevents progression of vascular disease. J Clin Invest. 2009;105:21–34.

    Google Scholar 

  50. Bogaard HJ, Kohtaro A, Noordegraaf AV, Voelkel NF. The right ventricle under pressure-cellular and molecular mechanisms of right heart failure in pulmonary hypertension. Chest. 2009;135:794–804.

    CAS  PubMed  Google Scholar 

  51. Baicu CF, Stroud JD, Livesay VA, et al. Changes in extracellular collage matrix alter myocardial systolic performance. Am J Physiol Heart Circ Physiol. 2003;284:H122–32.

    CAS  PubMed  Google Scholar 

  52. Lowes BD, Minobe W, Abraham WT, et al. Changes in gene expression in the intact human heart. Downregulation of alpha-myosin heavy chain in hypertrophied, failing ventricular myocardium. J Clin Invest. 1997;100:2315–24.

    CAS  PubMed Central  PubMed  Google Scholar 

  53. Gomez-Arroyo J, Mizuno S, Norbert F, et al. Metabolic gene remodelling and mitochondrial dysfunction in failing right ventricular hypertrophy secondary to pulmonary hypertension. Circ Heart Fail. 2013;6(1):136–44.

    CAS  PubMed Central  PubMed  Google Scholar 

  54. Can MM, Kaymaz C, Tanboga IH, Ozdemir N. Increased right ventricular glucose metabolism in patients with pulmonary arterial hypertension. Clin Nucl Med. 2011;36(9):743–8.

    PubMed  Google Scholar 

  55. Xu W, Koeck T, Lara A, Neumann D, DiFilippo FP, et al. Alternations of cellular bioenergetics in pulmonary artery endothelial cells. Proc Natl Acad Sci USA. 2007;104:1342–7.

    CAS  PubMed  Google Scholar 

  56. Lam CS, Roger VL, Rodeheffer RJ, Borlaug BA, Enders FT, Redfield MM. Pulmonary hypertension in heart failure with preserved ejection fraction: a community-based study. J Am Coll Cardiol. 2009;53:1119–26.

    PubMed Central  PubMed  Google Scholar 

  57. Townsley MI, Fu Z, Mathieu-Costello O, West JB. Pulmonary micro-vascular permeability. Responses to high vascular pressure after induction of pacing-induced heart failure in dogs. Circ Res. 1995;77:317–25.

    CAS  PubMed  Google Scholar 

  58. Guazzi M. Alveolar gas diffusion abnormalities in heart failure. J Card Fail. 2008;14:695–702.

    PubMed  Google Scholar 

  59. Dadfarmay S, Berkowitz R, Kim B, et al. Differentiating pulmonary arterial and venous hypertension and the implications for therapy. Congest Heart Fail. 2010;16:287–91.

    PubMed  Google Scholar 

  60. Waxman AB. Pulmonary hypertension in heart failure with preserved left ventricular function. Circulation. 2011;124:133–5.

    PubMed  Google Scholar 

  61. Ravi Y, Selvendiran K, Naidu SK, Meduru S, Sai-Sudhakar CB, et al. Pulmonary hypertension secondary to left-heart failure involves peroxynitrite-induced downregulation of PTEN in the lung. Hypertension. 2013;61:593–601.

    CAS  PubMed  Google Scholar 

  62. Rabinovitch ME. EVE and beyond, retro and prospective insights. Am J Physiol. 1999;277:L5–12.

    CAS  PubMed  Google Scholar 

  63. Kay J. Pulmonary vascular disease. In: Churg A, Myers J, Tazelaar H, Wright J, editors. Thurlbeck’s pathology of the lung. 3rd ed. New York, NY: Thieme; 2005. p. 893–905.

    Google Scholar 

  64. Piao L, Fang Y-H, Parikh KS, Arther SL, et al. GRK2- mediated inhibition of adrenergic and dopaminergic signaling in right ventricular hypertrophy: therapeutic implications in pulmonary hyper-tension. Circulation. 2012;126:2859–69.

    CAS  PubMed  Google Scholar 

  65. Nagendran J, Archer SL, Soliman D, et al. Phosphodiesterase type 5 is highly expressed in the hypertrophied human right ventricle, and acute inhibition of phosphodiesterase type 5 improves contractility. Circulation. 2007;116:238–48.

    CAS  PubMed  Google Scholar 

  66. Giaid A, Yanagisawa M, Langleben D, Michel RP, Levy R, Shennib H, Kimura S, Masaki T, Duguid WP, Stewart DJ. Expression of endothelin-1 in the lungs of patients with pulmonary hypertension. N Engl J Med. 1993;328:1732–9.

    CAS  PubMed  Google Scholar 

  67. Redfield M, Borlaug BA, Lewis GD, Mohammed SF, Braunwald E, et al. PhosphdiesteRasE-5 Inhibition to Improve CLinical Status and EXercise Capacity in Diastolic Heart Failure (RELAX) trial: rationale and design. Circ Heart Fail. 2012;5:653–9.

    PubMed Central  PubMed  Google Scholar 

  68. Maeder MT, Thompson BR, Brunner-La Rocca H, Kaye DM. Hemodynamic basis of exercise limitation in patients with heart failure and normal ejection fraction. J Am Coll Cardiol. 2010;56:855–63.

    PubMed  Google Scholar 

  69. Borlaug BA, Jaber WA, Ommen SR, et al. Diastolic relaxation and compliance reserve during dynamic exercise in heart failure with preserved ejection fraction. Heart. 2011;97:964–9.

    PubMed Central  PubMed  Google Scholar 

  70. Kshatriya S, Kozman H, Siddiqui D, Bhatta L, Liu K, Salah A, Ford T, Michiel R, Villarreal D. The cardiorenal syndrome in heart failure: an evolving paradigm. Am J Med Sci. 2010;340(1):33–7.

    PubMed  Google Scholar 

  71. Benotti JR, Dalen JE. Then natural history of pulmonary embolism. Clin Chest Med. 1984;5(3):403.

    CAS  PubMed  Google Scholar 

  72. Delcroix M, Vonk-Noordegraaf A, Fadel E, et al. Vascular and right ventricular remodeling in chronic thromboembolic pulmonary hypertension. Eur Respir J. 2013;41:224–32.

    PubMed  Google Scholar 

  73. Greyson CR. Right heart failure in the intensive care unit. Curr Opin Crit Care. 2012;18:424–31.

    PubMed  Google Scholar 

  74. Greyson CR, Schwartz GG, Lu L, et al. Calpain inhibition attenuates right ventricular contractile dysfunction after acute pressure overload. J Mol Cell Cardiol. 2008;44:59–68.

    CAS  PubMed Central  PubMed  Google Scholar 

  75. Dewachter C, Dewachter L, Rondelet B, et al. Activation of apoptotic path-ways in experimental acute afterload-induced right ventricular failure. Crit Care Med. 2010;38:1405–13.

    PubMed  Google Scholar 

  76. Cuttica MJ, Kalhan R, Shlobin OA, et al. Categorization and impact of pulmonary hypertension in patients with advanced COPD. Respir Med. 2010;104:1877–82.

    PubMed  Google Scholar 

  77. Thabut G, Dauriat G, Stern JB, et al. Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplant. Chest. 2005;127:1531–6.

    PubMed  Google Scholar 

  78. Hoeper MM, Barbera JA, Channick RN, et al. Diagnosis, assessment and treatment of nonpulmonary arterial hypertension pulmonary hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S85–96.

    PubMed  Google Scholar 

  79. Stone AC, Machan JT, Mazer J, et al. Echocardiographic evidence of pulmonary hypertension is associated with increased one year mortality in patients admitted with COPD. Lung. 2011;189:207–12.

    PubMed  Google Scholar 

  80. Timms RM, Khaja FU, Williams GW. Hemodynamic response to oxygen therapy in COPD. Ann Intern Med. 1985;102:29–36.

    CAS  PubMed  Google Scholar 

  81. Wright JL, Petty T, Thurlbeck WM. Analysis of the structure of the muscular pulmonary arteries in patients with pulmonary hypertension and COPD. National Institute of Health nocturnal oxygen therapy trial. Lung. 1992;170:109–24.

    CAS  PubMed  Google Scholar 

  82. Seimetz M, Parajuli N, Pichl A, et al. Inducible NOS inhibition reverses tobacco-smoke-induced emphysema and pulmonary hypertension in mice. Cell. 2011;147:293–305.

    CAS  PubMed  Google Scholar 

  83. Ulrich S, Hersberger M, Fischler M, et al. Genetic polymorphism of the serotonin transporter, but not the 2a receptor or nitric oxide synthetase, are associated with pulmonary hypertension in COPD. Respiration. 2010;79:288–95.

    CAS  PubMed  Google Scholar 

  84. Lorenzen JM, Nickel N, Kramer R, Golpon H, et al. Osteopontin in patients with idiopathic pulmonary hypertension. Chest. 2011;139(5):1010–7.

    CAS  PubMed  Google Scholar 

  85. Rosenberg M, Meyer FJ, Grueg Frey N, et al. Osteopontin predicts adverse right ventricular remodeling and dysfunction in pulmonary hypertension. Eur J Clin Invest. 2012;42(9):933–42.

    CAS  PubMed  Google Scholar 

  86. Carabello BA. Evolution of the study of left ventricular function: everything old is new again. Circulation. 2002;105:2701–3.

    PubMed  Google Scholar 

  87. Tandri H, Daya SK, Nari K, Bomma C, Bluemke DA. Normal reference values for the adult right ventricle by magnetic resonance Imaging. Am J Cardiol. 2006;98:1660–4.

    PubMed  Google Scholar 

  88. Schiebler ML, Bhalla S, Runo WJ, Francois FJ, et al. Magnetic resonance and computed tomography imaging of the structural and functional changes of pulmonary arterial hypertension. J Thorac Imaging. 2013;28:178–95.

    PubMed  Google Scholar 

  89. Hundley WG, Bluemke DA, Finn JP, Wesley DJ, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 Expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Document. Circulation. 2010;121(22):2462–508.

    PubMed  Google Scholar 

  90. Alfakih K, Reid S, Jones T, et al. Assessment of ventricular function and mass by cardiac magnetic resonance imaging. Eur Radiol. 2004;14:1813–22.

    PubMed  Google Scholar 

  91. Chahal H, Johnson C, Tnadri H, et al. Relation of cardiovascular risk factors to right ventricular structure and function as determined by magnetic resonance imaging (results from the multi-ethnic study of atherosclerosis). Am J Cardiol. 2010;106:110–6.

    PubMed Central  PubMed  Google Scholar 

  92. Kurtz CE. Right ventricular anatomy, function, and echocardiographic evaluation. In: Otto C, editor. The practice of clinical echocardiography. 4th ed. Philadelphia, PA: Elsevier Saunders; 2012. p. 164–662.

    Google Scholar 

  93. Grapsa J, Dawson D, Nihoyannopoulos P. Assessment of right ventricular structure and function in pulmonary hypertension. J Cardiovasc Ultrasound. 2011;19(3):115–25.

    PubMed Central  PubMed  Google Scholar 

  94. Lima JA, Guzman PA, Yin FC, Weiss JC, et al. Septal geometry in the unloaded human heart. Circulation. 1984;74:463–8.

    Google Scholar 

  95. Kjaergaard J, Peterson CL, Kjaer A, Schaadt BK, Oh J, et al. Evaluation of right ventricular volume and function by 2D and 3D echocardiography compared to MRI. Eur J Echocardiogr. 2006;7(4):430–8.

    PubMed  Google Scholar 

  96. Fisher MR, Forfia PR, Chamera E, Housten-Harris T, et al. Accuracy of Doppler echocardiography in the hemodynamic assessment of pulmonary hypertension. Am J Respir Crit Care Med. 2009;179(7):615.

    PubMed  Google Scholar 

  97. Rich JD, Shah SJ, Swamy RS, Kamp A, Rich S. Inaccuracy of Doppler echocardiographic estimate of pulmonary arterial pressure in patients with pulmonary hypertension: implications for clinical practice. Chest. 2011;139(5):988–93.

    PubMed  Google Scholar 

  98. Giardini A, Tacy TA. Non-invasive estimation of pressure gradients in regurgitant jets: an overdue consideration. Eur J Echocardiogr. 2008;9(5):578–84.

    PubMed  Google Scholar 

  99. Ghio S, Klersy C, Magrini G, D’Armini Vigano M. Prognostic relevance of the echocardiographic assessment of right ventricular function in patients with idiopathic pulmonary arterial hypertension. Int J Cardiol. 2010;140:272–8.

    PubMed  Google Scholar 

  100. Maron BA. Targeting Neurohumoral Signalling to Treat Pulmonary Hypertension: the right ventricle coming into focus. Circulation. 2012;126(24):2806–8.

    PubMed  Google Scholar 

  101. Galie N, Branzi A, et al. Pharmacological Impact on right ventricular remodeling in PAH. Eur Heart J Suppl. 2007;9:H68–74.

    Google Scholar 

  102. Judge EP, Gaine SP. Management of pulmonary arterial hypertension. Curr Opin Crit Care. 2013;19(1):44–50.

    PubMed  Google Scholar 

  103. D’Alonzo GE, Barst RJ, Ayres SM, et al. Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Ann Intern Med. 1991;115(5):343–9.

    PubMed  Google Scholar 

  104. Raymond LB, Miller DP, Barst RJ, McGoon MD, et al. An evaluation of long term survival from time of diagnosis in pulmonary hypertension from the REVEAL Registry. Chest. 2012;142:448–56.

    Google Scholar 

  105. Papierniak ES, Lowenthal DT, Mubarak K. Pulmonary arterial hypertension: classification and therapy with a focus on prostaglandin Analog. Am J Ther. 2012;19(4):300–14.

    PubMed  Google Scholar 

  106. Morrison K, Ernst R, Hess P, et al. Selexipag: a selective prostacyclin receptor agonist that does not affect rate gastric function. J Pharmacol Exp Ther. 2010;335:249–55.

    CAS  PubMed  Google Scholar 

  107. Ghofrani HA, Seeger W, Grimminger F. Imatinib for the treatment of pulmonary arterial hypertension. N Engl J Med. 2005;353:1412–3.

    CAS  PubMed  Google Scholar 

  108. Sidharta PN, Giersbergen PL, Halabi A, et al. Macitentan: entry-into-human study with a new endothelium receptor antagonist. Eur J Clin Pharmacol. 2011;67:977–84.

    CAS  PubMed Central  PubMed  Google Scholar 

  109. Semigran M, Bonderman D, Ghio S, Scalise AV, et al. Left ventricular systolic dysfunction associated with pulmonary hypertension Riociguat Trial (LEPHT). Late-breaking clinical abstracts. Circulation. 2012;126(23):2776–99.

    Google Scholar 

  110. Belik J. Riocigat, an oral soluble guanylate cyclase stimulator for the treatment of pulmonary hypertension. Curr Opin Investig Drugs. 2009;10:971–9.

    CAS  PubMed  Google Scholar 

  111. Macchia A, Marhioli R, Tognoni G, et al. Systematic review of trials using vasodilators in pulmonary arterial hypertension: why a new approach is needed. Am Heart J. 2010;159(2):245–57.

    CAS  PubMed  Google Scholar 

  112. Abramson SV, Burke JF, Kelly JJ, Kitchen JG, Phiambois TP, et al. Pulmonary hypertension predicts mortality and morbidity in patients with dilated cardiomyopathy. Ann Intern Med. 1992;116:888–95.

    CAS  PubMed  Google Scholar 

  113. Guazzi M, Vicenzi M, Arean R, Guazzi M. PDE5 inhibition with sildenafil Improves left ventricular diastolic dysfunction, cardiac geometry and clinical status in patient with stable systolic heart failure-results of a 1-year, prospective, randomized, placebo controlled Study. Circ Heart Fail. 2011;4:8–17.

    CAS  PubMed  Google Scholar 

  114. Orr R, Smith LJ, Cuttica MJ. Pulmonary hypertension in advanced COPD. Curr Opin Pulm Med. 2012;18:138–43.

    PubMed  Google Scholar 

  115. Blanco I, Gimeno E, Munoz PA, et al. Hemodynamic and gas exchanges effects of sildenafil in patients with COPD and pulmonary hypertension. Am J Respir Crit Care Med. 2010;181:270–8.

    CAS  PubMed  Google Scholar 

  116. Rietema H, Holverda S, Bogaard HJ, et al. Sildenafil treatment in COPD does not affect stroke volume or exercise capacity. Eur Respir J. 2008;31:759–64.

    CAS  PubMed  Google Scholar 

  117. Valerio G, Bracciale P, Grazia D’Agostinao A. Effect of bosentan upon pulmonary hypertension in COPD. Ther Adv Respir Dis. 2009;3:15–21.

    PubMed  Google Scholar 

  118. Fedullo PF, Auger WR, Kerr KM, et al. Chronic thromboembolic pulmonary hypertension. N Engl J Med. 2001;345:1465–72.

    CAS  PubMed  Google Scholar 

  119. Dartevelle P, Fadel E, Mussot S, et al. Chronic thromboembolic pulmonary hypertension. Eur Respir J. 2004;23:637–48.

    CAS  PubMed  Google Scholar 

  120. Surie S, Bouma BJ, Bruin-Bon RA, Harziyenka M, et al. Time course of restoration of systolic and diastolic right ventricular function after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Am Heart J. 2011;161: 1046–52.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Alberta Hospital, 2C2, WMC, 8440 112 Street, Edmonton, AB, Canada, T6G 2B7

    Joseph Szeman Wong MBBS, MRCP, FHKCP, FRCPC

  2. 2C2 W.C. Mackenzie Health Sciences Centre, Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta and Hospitals, 727, Todd Landing NW, Edmonton, AB, Canada, T6G 2B7

    Bodh I. Jugdutt MD, MSc, DM, FRCPC

Authors
  1. Joseph Szeman Wong MBBS, MRCP, FHKCP, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bodh I. Jugdutt MD, MSc, DM, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph Szeman Wong MBBS, MRCP, FHKCP, FRCPC .

Editor information

Editors and Affiliations

  1. Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta and Hospitals, Edmonton, Alberta, Canada

    Bodh I. Jugdutt

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Wong, J.S., Jugdutt, B.I. (2014). Aging and Right Ventricular Failure from Pulmonary Hypertension: Effect of Right Ventricular and Pulmonary Artery Remodeling. In: Jugdutt, B. (eds) Aging and Heart Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0268-2_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-0268-2_19

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-0267-5

  • Online ISBN: 978-1-4939-0268-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation