Emerging role of angiogenesis in adaptive and maladaptive right ventricular remodeling in pulmonary hypertension

Andrea L. Frump, Sébastien Bonnet, Vinicio A. de Jesus Perez, Tim Lahm

Research output: Contribution to journalReview article

10 Scopus citations

Abstract

Right ventricular (RV) function is the primary prognostic factor for both morbidity and mortality in pulmonary hypertension (PH). RV hypertrophy is initially an adaptive physiological response to increased overload; however, with persistent and/or progressive afterload increase, this response frequently transitions to more pathological maladaptive remodeling. The mechanisms and disease processes underlying this transition are mostly unknown. Angiogenesis has recently emerged as a major modifier of RV adaptation in the setting of pressure overload. A novel paradigm has emerged that suggests that angiogenesis and angiogenic signaling are required for RV adaptation to afterload increases and that impaired and/or insufficient angiogenesis is a major driver of RV decompensation. Here, we summarize our current understanding of the concepts of maladaptive and adaptive RV remodeling, discuss the current literature on angiogenesis in the adapted and failing RV, and identify potential therapeutic approaches targeting angiogenesis in RV failure.

Original languageEnglish (US)
Pages (from-to)L443-L460
JournalAmerican Journal of Physiology - Lung Cellular and Molecular Physiology
Volume314
Issue number3
DOIs
StatePublished - Mar 2018

ASJC Scopus subject areas

  • Physiology
  • Pulmonary and Respiratory Medicine
  • Physiology (medical)
  • Cell Biology

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