Diagnosis and Treatment of Right Heart Failure in Pulmonary Vascular Diseases: A National Heart, Lung, and Blood Institute Workshop

Author:

Leopold Jane A.ORCID,Kawut Steven M.1ORCID,Aldred Micheala A.2,Archer Stephen L.3,Benza Ray L.4ORCID,Bristow Michael R.5ORCID,Brittain Evan L.6,Chesler Naomi7ORCID,DeMan Frances S.8,Erzurum Serpil C.9,Gladwin Mark T.10ORCID,Hassoun Paul M.11,Hemnes Anna R.12ORCID,Lahm Tim2,Lima Joao A.C.12ORCID,Loscalzo JosephORCID,Maron Bradley A.13,Mercer Rosa Laura14,Newman John H.12,Redline Susan15ORCID,Rich Stuart16,Rischard Franz17,Sugeng Lissa18,Tang W.H. Wilson19,Tedford Ryan J.20,Tsai Emily J.21ORCID,Ventetuolo Corey E.22ORCID,Zhao YouYang23ORCID,Aggarwal Neil R.24,Xiao Lei24,Cai Hua Linda,Cai Lu,Chen Xiongwen,Elinoff Jason M.,Freed Benjamin H.,Frump Andrea L.,Goss Kara N.,Gray Michael P.,Huang Wei,Kolb Todd M.,Simon Marc A.,Solomon Michael A.,Spiekerkoetter Edda,Vanderpool Rebecca R.,Zou Ming-Hui,Chen Yingjie,Bishow Adhikari,Shi Scarlet,Weinmann Gail G.,Wong Renee

Affiliation:

1. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. Department of Medicine (S.M.K.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

2. Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis (M.A.A., T.L.).

3. Department of Medicine, Queen’s University, Kingston, Ontario, Canada (S.L.A.).

4. Department of Medicine, Allegheny General Hospital, Pittsburgh, PA (R.L.B.).

5. Department of Medicine, University of Colorado, Denver (M.R.B.).

6. Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research Center (E.L.B.), Vanderbilt University Medical Center, Nashville, TN.

7. Department of Biomedical Engineering, University of Wisconsin-Madison College of Engineering (N.C.).

8. Department of Pulmonary Medicine, PHEniX laboratory, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands (F.S.D.).

9. Lerner Research Institute (S.C.E.), Cleveland Clinic, OH.

10. Department of Medicine, Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute UPMC and the University of Pittsburgh School of Medicine, PA (M.T.G.).

11. Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.H.).

12. Department of Medicine (A.R.H., J.A.C.L., J.H.N.), Vanderbilt University Medical Center, Nashville, TN.

13. Department of Cardiology, Boston VA Healthcare System, West Roxbury, MA (B.A.M.).

14. Department of Pediatrics (L.M.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

15. Division of Cardiovascular Medicine, Departments of Medicine and Neurology (S. Redline), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

16. Department of Medicine (S. Rich), Northwestern University Feinberg School of Medicine, Chicago, IL.

17. Department of Medicine, University of Arizona, Tucson (F.R.).

18. Department of Medicine, Yale School of Medicine, New Haven, CT (L.S.).

19. Department of Cardiovascular Medicine, Heart and Vascular Institute (W.H.W.T.), Cleveland Clinic, OH.

20. Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston (R.J.T.).

21. Division of Cardiology, Columbia University Vagelos College of Physicians and Surgeons, NY (E.J.T.).

22. Department of Medicine, Alpert Medical School of Brown University, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI (C.E.V.).

23. Departments of Pediatrics (Division of Critical Care), Pharmacology, and Medicine (Y.Z.), Northwestern University Feinberg School of Medicine, Chicago, IL.

24. Division of Lung Diseases, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD (N.R.A., L.X.).

Abstract

Right ventricular dysfunction is a hallmark of advanced pulmonary vascular, lung parenchymal, and left heart disease, yet the underlying mechanisms that govern (mal)adaptation remain incompletely characterized. Owing to the knowledge gaps in our understanding of the right ventricle (RV) in health and disease, the National Heart, Lung, and Blood Institute commissioned a working group to identify current challenges in the field. These included a need to define and standardize normal RV structure and function in populations; access to RV tissue for research purposes and the development of complex experimental platforms that recapitulate the in vivo environment; and the advancement of imaging and invasive methodologies to study the RV within basic, translational, and clinical research programs. Specific recommendations were provided, including a call to incorporate precision medicine and innovations in prognosis, diagnosis, and novel RV therapeutics for patients with pulmonary vascular disease.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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