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Arch Cardiovasc Dis. 2015 Oct;108(10):519-29. doi: 10.1016/j.acvd.2015.05.008. Epub 2015 Jul 13.

Advancing knowledge of right ventricular pathophysiology in chronic pressure overload: Insights from experimental studies.

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Laboratory of Surgical Research, Marie-Lannelongue Hospital, Paris Sud University, 92350 Le Plessis Robinson, France; Thoracic and Cardiovascular Surgery, University Hospital of Rennes, 35033 Rennes, France. Electronic address:
Laboratory of Surgical Research, Marie-Lannelongue Hospital, Paris Sud University, 92350 Le Plessis Robinson, France.
Transplant and Stem Cell Immunobiology Laboratory (TSI Lab), University of Hamburg, Hamburg, Germany.


The right ventricle (RV) has to face major changes in loading conditions due to cardiovascular diseases and pulmonary vascular disorders. Clinical experience supports evidence that the RV better compensates for volume than for pressure overload, and for chronic than for acute changes. For a long time, right ventricular (RV) pathophysiology has been restricted to patterns extrapolated from left heart studies. However, the two ventricles are anatomically, haemodynamically and functionally distinct. RV metabolic properties may also result in a different behaviour in response to pathological conditions compared with the left ventricle. In this review, current knowledge of RV pathophysiology is reported in the setting of chronic pressure overload, including recent experimental findings and emerging concepts. After a time-varying compensated period with preserved cardiac output despite overload conditions, RV failure finally occurs, leading to death. The underlying mechanisms involved in the transition from compensatory hypertrophy to maladaptive remodelling are not completely understood.


Circulation pulmonaire; Couplage ventriculo-artériel; Experimental research; Hypertension pulmonaire; Pulmonary circulation; Pulmonary hypertension; Recherche expérimentale; Right ventricle; Ventricular-arterial coupling; Ventricule droit

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