scholarly journals 5-HT2B Receptor Antagonists Inhibit Fibrosis and Protect from RV Heart Failure

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Wiebke Janssen ◽  
Yves Schymura ◽  
Tatyana Novoyatleva ◽  
Baktybek Kojonazarov ◽  
Mario Boehm ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Receptor Antagonist ◽  
Chronic Treatment ◽  
Heart Function ◽  
Cardiac Fibroblasts ◽  
Heart Catheterization ◽  
Receptor Antagonists ◽  
Right Heart ◽  
Right Heart Function ◽  
Ventricular Fibrosis

Objective. The serotonin (5-HT) pathway was shown to play a role in pulmonary hypertension (PH), but its functions in right ventricular failure (RVF) remain poorly understood. The aim of the current study was to investigate the effects of Terguride (5-HT2A and 2B receptor antagonist) or SB204741 (5-HT2B receptor antagonist) on right heart function and structure upon pulmonary artery banding (PAB) in mice.Methods. Seven days after PAB, mice were treated for 14 days with Terguride (0.2 mg/kg bid) or SB204741 (5 mg/kg day). Right heart function and remodeling were assessed by right heart catheterization, magnetic resonance imaging (MRI), and histomorphometric methods. Total secreted collagen content was determined in mouse cardiac fibroblasts isolated from RV tissues.Results. Chronic treatment with Terguride or SB204741 reduced right ventricular fibrosis and showed improved heart function in mice after PAB. Moreover, 5-HT2B receptor antagonists diminished TGF-beta1 induced collagen synthesis of RV cardiac fibroblastsin vitro.Conclusion. 5-HT2B receptor antagonists reduce collagen deposition, thereby inhibiting right ventricular fibrosis. Chronic treatment prevented the development and progression of pressure overload-induced RVF in mice. Thus, 5-HT2B receptor antagonists represent a valuable novel therapeutic approach for RVF.

scholarly journals Right atrial mechanics provide useful insight in pediatric pulmonary hypertension

2018 ◽  
Vol 8 (1) ◽  
pp. 204589321875485 ◽  
Author(s):  
Kyle D. Hope ◽  
Renzo José Carlos Calderón Anyosa ◽  
Yan Wang ◽  
Andrea E. Montero ◽  
Tomoyuki Sato ◽  
...  
Keyword(s):  
Heart Function ◽  
High Sensitivity ◽  
Right Heart Catheterization ◽  
Adverse Outcomes ◽  
Right Atrial ◽  
Heart Catheterization ◽  
Right Heart ◽  
Functional Changes ◽  
Right Heart Function ◽  
D Loop

Right atrial (RA) mechanics have been studied infrequently in children in the past due to technical constraints. With the advent of strain imaging, RA physiology can now be studied in greater detail. The principal aim of this study was to describe functional changes in right heart mechanics of children with idiopathic pulmonary arterial hypertension (PAH), by using new applications of RA strain. In this retrospective study, we evaluated RA mechanics of 20 patients (age range = 3–23 years) with PAH and 18 control patients. RA longitudinal strain (RALS) and longitudinal displacement (LD) were calculated by speckle-tracking echocardiography. RALS was plotted against LD, producing a characteristic strain-displacement (S-D) loop. Standard indices of right heart function and right heart catheterization data were obtained. Patients were clinically subdivided into “compensated” and “decompensated” PAH. A chart review was performed to identify patients who subsequently developed adverse outcomes, including death, awaiting or received lung and/or heart transplantation. RALS was significantly lower in decompensated PAH compared with both controls and compensated PAH. Area enclosed by S-D loops differed significantly between the compensated and decompensated PAH subgroups (5.33 [3.90–9.44] versus 1.83 [1.17–2.36], P < 0.05). S-D loop area and RALS possessed high sensitivity and specificity compared to other parameters for identifying children with PAH who subsequently developed adverse outcomes. In particular, their sensitivities and specificities were greatly superior compared to those of tricuspid annular plane systolic excursion (TAPSE). RALS may represent a useful metric for assessing right ventricular (RV) dysfunction. S-D loops, composed over an entire cardiac cycle, may present useful, composite information regarding both systolic and diastolic right heart function. RA mechanics may serve as useful tools for identifying patients with more severe PAH, who are at risk for future adverse outcomes associated with RV failure.

scholarly journals Right Ventricular Function Predicts Adverse Clinical Outcomes in Patients With Chronic Thromboembolic Pulmonary Hypertension: A Three-Dimensional Echocardiographic Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Yidan Li ◽  
Lirong Liang ◽  
Dichen Guo ◽  
Yuanhua Yang ◽  
Juanni Gong ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Clinical Outcomes ◽  
Heart Function ◽  
Three Dimensional ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Heart Catheterization ◽  
Right Heart ◽  
Thromboembolic Pulmonary Hypertension ◽  
Rv Function

Background: Right ventricular (RV) function plays a vital role in the prognosis of patients with chronic thromboembolic pulmonary hypertension (CTEPH). We used new machine learning (ML)-based fully automated software to quantify RV function using three-dimensional echocardiography (3DE) to predict adverse clinical outcomes in CTEPH patients.Methods: A total of 151 consecutive CTEPH patients were registered in this prospective study between April 2015 and July 2019. New ML-based methods were used for data management, and quantitative analysis of RV volume and ejection fraction (RVEF) was performed offline. RV structural and functional parameters were recorded using 3DE. CTEPH was diagnosed using right heart catheterization, and 62 patients underwent cardiac magnetic resonance to assess right heart function. Adverse clinical outcomes were defined as PH-related hospitalization with hemoptysis or increased RV failure, including conditions requiring balloon pulmonary angioplasty or pulmonary endarterectomy, as well as death.Results: The median follow-up time was 19.7 months (interquartile range, 0.5–54 months). Among the 151 CTEPH patients, 72 experienced adverse clinical outcomes. Multivariate Cox proportional-hazard analysis showed that ML-based 3DE analysis of RVEF was a predictor of adverse clinical outcomes (hazard ratio, 1.576; 95% confidence interval (CI), 1.046~2.372; P = 0.030).Conclusions: The new ML-based 3DE algorithm is a promising technique for rapid 3D quantification of RV function in CTEPH patients.

Copeptin reliably reflects longitudinal right ventricular function

2021 ◽  
pp. 000456322198936
Author(s):  
Melissa Harbrücker ◽  
Michèle Natale ◽  
Seung-Hyun Kim ◽  
Julian Müller ◽  
Uzair Ansari ◽  
...  
Keyword(s):  
Regression Model ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Heart Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
The Novel ◽  
Right Heart ◽  
Right Heart Function

Background Data is limited evaluating novel biomarkers in right ventricular dysfunction. Normal right heart function improves the prognosis of patients with heart failure. Therefore, this study investigates the association between the novel biomarker copeptin and right heart function compared to NT-proBNP. Methods Patients undergoing routine echocardiography were enrolled prospectively. Right ventricular function was assessed by tricuspid annular plane systolic excursion (TAPSE) and further right ventricular and atrial parameters. Exclusion criteria were age under 18 years, left ventricular ejection fraction < 50% and moderate to severe valvular heart disease. Blood samples were taken for biomarker measurements within 72 h of echocardiography. Results Ninety-one patients were included. Median values of copeptin increased significantly according to decreasing values of TAPSE ( P = 0.001; right heart function grade I: tricuspid annular plane systolic excursion; TAPSE > 24 mm: 5.20 pmol/L; grade II: TAPSE 18–24 mm: 8.10 pmol/L; grade III: TAPSE < 18 mm: 26.50 pmol/L). Copeptin concentrations were able to discriminate patients with decreased right heart function defined as TAPSE < 18 mm (area under the curves [AUC]: copeptin: 0.793; P = 0.001; NT-proBNP: 0.805; P = 0.0001). Within a multivariable linear regression model, copeptin was independently associated with TAPSE (copeptin: T: –4.43; P = 0.0001; NT-proBNP: T: –1.21; P = 0.23). Finally, copeptin concentrations were significantly associated with severely reduced right heart function (TAPSE < 18 mm) within a multivariate logistic regression model (copeptin: odds ratio: 0.94; 95% confidence interval: 0.911–0.975; P = 0.001). Conclusions This study demonstrates that the novel biomarker copeptin reflects longitudinal right heart function assessed by standardized transthoracic echocardiography compared with NT-proBNP.

Shape of the Right Ventricular Doppler Envelope Predicts Hemodynamics and Right Heart Function in Pulmonary Hypertension

2011 ◽  
Vol 183 (2) ◽  
pp. 268-276 ◽  
Author(s):  
Jeffrey S. Arkles ◽  
Alexander R. Opotowsky ◽  
Jason Ojeda ◽  
Frances Rogers ◽  
Tong Liu ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Heart Function ◽  
Right Heart ◽  
Right Heart Function ◽  
The Right
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