Treatment Targets for Right Ventricular Dysfunction in Pulmonary Arterial Hypertension

ABSTRACT: Highlights • RV dysfunction is the strongest predictor of mortality in PAH.• Unfortunately, there are no effective therapies for RV failure.• Differences between the left ventricle and RV may allow for RV-enhancing or RV-directed therapies.• Here, we highlight the known molecular mechanisms that promote RV dysfunction in PAH and the ongoing clinical trials investigating RV function as a therapeutic target. Summary Right ventricle (RV) dysfunction is the strongest predictor of mortality in pulmonary arterial hypertension (PAH), but, at present, there are no therapies directly targeting the failing RV. Although there are shared molecular mechanisms in both RV and left ventricle (LV) dysfunction, there are important differences between the 2 ventricles that may allow for the development of RV-enhancing or RV-directed therapies. In this review, we discuss the current understandings of the dysregulated pathways that promote RV dysfunction, highlight RV-enriched or RV-specific pathways that may be of particular therapeutic value, and summarize recent and ongoing clinical trials that are investigating RV function in PAH. It is hoped that development of RV-targeted therapies will improve quality of life and enhance survival for this deadly disease. Central Illustration

SUBMITTER: Prisco S 

PROVIDER: S-EPMC7775863 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature