Right heart reverse remodeling: “facta non verba”
Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and arterial narrowing, leading to a progressive rise in right ventricular (RV) afterload and poor survival outcomes. PAH prognosis largely depends on RV remodeling and function: when the increased afterload exce...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | International Journal of Cardiology Congenital Heart Disease |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666668525000047 |
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| author | Tommaso Recchioni Giovanna Manzi Alexandra Mihai Francesca Ileana Adamo Annalisa Caputo Domenico Filomena Giorgia Serino Silvia Papa Nadia Cedrone Carmine Dario Vizza Roberto Badagliacca |
| author_facet | Tommaso Recchioni Giovanna Manzi Alexandra Mihai Francesca Ileana Adamo Annalisa Caputo Domenico Filomena Giorgia Serino Silvia Papa Nadia Cedrone Carmine Dario Vizza Roberto Badagliacca |
| author_sort | Tommaso Recchioni |
| collection | DOAJ |
| description | Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and arterial narrowing, leading to a progressive rise in right ventricular (RV) afterload and poor survival outcomes. PAH prognosis largely depends on RV remodeling and function: when the increased afterload exceeds the RV's adaptive capacity, ventricular-arterial uncoupling occurs, ultimately causing right heart failure and death. In this clinical setting the primary treatment goal is to achieve low mortality risk and right heart reverse remodeling (RHRR). Unfortunately, the definition of RHRR vary across studies and imaging modalities (echocardiography or Cardiac Magnetic Resonance). The likelihood of RHRR increases with a significant reduction in pulmonary vascular resistance (PVR) from baseline, ideally by at least 50 %. Evidence supports initial triple therapy, including parenteral prostanoids, as the most effective approach to reduce PVR enough to facilitate RHRR and thus achieve the low-risk status. |
| format | Article |
| id | doaj-art-0484a2e5105e4de299278706d0a555fa |
| institution | Kabale University |
| issn | 2666-6685 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj-art-0484a2e5105e4de299278706d0a555fa2025-01-24T04:45:48ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852025-03-0119100568Right heart reverse remodeling: “facta non verba”Tommaso Recchioni0Giovanna Manzi1Alexandra Mihai2Francesca Ileana Adamo3Annalisa Caputo4Domenico Filomena5Giorgia Serino6Silvia Papa7Nadia Cedrone8Carmine Dario Vizza9Roberto Badagliacca10Department of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyUnità di Medicina Interna, Ospedale S. Pertini, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, ItalyDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161, Rome, Italy; Corresponding author.Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and arterial narrowing, leading to a progressive rise in right ventricular (RV) afterload and poor survival outcomes. PAH prognosis largely depends on RV remodeling and function: when the increased afterload exceeds the RV's adaptive capacity, ventricular-arterial uncoupling occurs, ultimately causing right heart failure and death. In this clinical setting the primary treatment goal is to achieve low mortality risk and right heart reverse remodeling (RHRR). Unfortunately, the definition of RHRR vary across studies and imaging modalities (echocardiography or Cardiac Magnetic Resonance). The likelihood of RHRR increases with a significant reduction in pulmonary vascular resistance (PVR) from baseline, ideally by at least 50 %. Evidence supports initial triple therapy, including parenteral prostanoids, as the most effective approach to reduce PVR enough to facilitate RHRR and thus achieve the low-risk status.http://www.sciencedirect.com/science/article/pii/S2666668525000047Right heart reverse remodelingPulmonary arterial hypertensionEchocardiographyCardiac magnetic resonanceRight heart catheterization |
| spellingShingle | Tommaso Recchioni Giovanna Manzi Alexandra Mihai Francesca Ileana Adamo Annalisa Caputo Domenico Filomena Giorgia Serino Silvia Papa Nadia Cedrone Carmine Dario Vizza Roberto Badagliacca Right heart reverse remodeling: “facta non verba” International Journal of Cardiology Congenital Heart Disease Right heart reverse remodeling Pulmonary arterial hypertension Echocardiography Cardiac magnetic resonance Right heart catheterization |
| title | Right heart reverse remodeling: “facta non verba” |
| title_full | Right heart reverse remodeling: “facta non verba” |
| title_fullStr | Right heart reverse remodeling: “facta non verba” |
| title_full_unstemmed | Right heart reverse remodeling: “facta non verba” |
| title_short | Right heart reverse remodeling: “facta non verba” |
| title_sort | right heart reverse remodeling facta non verba |
| topic | Right heart reverse remodeling Pulmonary arterial hypertension Echocardiography Cardiac magnetic resonance Right heart catheterization |
| url | http://www.sciencedirect.com/science/article/pii/S2666668525000047 |
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