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Right ventricular failure following chronic pressure overload is associated with reduction in left ventricular mass: evidence for atrophic remodeling.
J Am Coll Cardiol. 2011 Feb 22; 57(8):921-8.JACC

Abstract

OBJECTIVES

We sought to study whether patients with right ventricular failure (RVF) secondary to chronic thromboembolic pulmonary hypertension (CTEPH) have reduced left ventricular (LV) mass, and whether LV mass reduction is caused by atrophy.

BACKGROUND

The LV in patients with CTEPH is underfilled (unloaded). LV unloading may cause atrophic remodeling that is associated with diastolic and systolic dysfunction.

METHODS

We studied LV mass using cardiac magnetic resonance imaging (MRI) in 36 consecutive CTEPH patients (before/after pulmonary endarterectomy [PEA]) and 11 healthy volunteers selected to match age and sex of patients. We studied whether LV atrophy is present in monocrotaline (MCT)-injected rats with RVF or controls by measuring myocyte dimensions and performing in situ hybridization.

RESULTS

At baseline, CTEPH patients with RVF had significantly lower LV free wall mass indexes than patients without RVF (35 ± 6 g/m(2) vs. 44 ± 7 g/m(2), p = 0.007) or volunteers (42 ± 6 g/m(2), p = 0.006). After PEA, LV free wall mass index increased (from 38 ± 6 g/m(2) to 44 ± 9 g/m(2), p = 0.001), as right ventricular (RV) ejection fraction improved (from 31 ± 8% to 56 ± 12%, p < 0.001). Compared with controls, rats with RVF had reduced LV free wall mass and smaller LV free wall myocytes. Expression of atrial natriuretic peptide was higher, whereas that of α-myosin heavy chain and sarcoplasmic reticulum calcium ATPase-2 were lower in RVF than in controls, both in RV and LV.

CONCLUSIONS

RVF in patients with CTEPH is associated with reversible reduction in LV free wall mass. In a rat model of RVF, myocyte shrinkage due to atrophic remodeling contributed to reduction in LV free wall mass.

Authors+Show Affiliations

Heart Failure Research Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21329838

Citation

Hardziyenka, Maxim, et al. "Right Ventricular Failure Following Chronic Pressure Overload Is Associated With Reduction in Left Ventricular Mass: Evidence for Atrophic Remodeling." Journal of the American College of Cardiology, vol. 57, no. 8, 2011, pp. 921-8.
Hardziyenka M, Campian ME, Reesink HJ, et al. Right ventricular failure following chronic pressure overload is associated with reduction in left ventricular mass: evidence for atrophic remodeling. J Am Coll Cardiol. 2011;57(8):921-8.
Hardziyenka, M., Campian, M. E., Reesink, H. J., Surie, S., Bouma, B. J., Groenink, M., Klemens, C. A., Beekman, L., Remme, C. A., Bresser, P., & Tan, H. L. (2011). Right ventricular failure following chronic pressure overload is associated with reduction in left ventricular mass: evidence for atrophic remodeling. Journal of the American College of Cardiology, 57(8), 921-8. https://doi.org/10.1016/j.jacc.2010.08.648
Hardziyenka M, et al. Right Ventricular Failure Following Chronic Pressure Overload Is Associated With Reduction in Left Ventricular Mass: Evidence for Atrophic Remodeling. J Am Coll Cardiol. 2011 Feb 22;57(8):921-8. PubMed PMID: 21329838.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Right ventricular failure following chronic pressure overload is associated with reduction in left ventricular mass: evidence for atrophic remodeling. AU - Hardziyenka,Maxim, AU - Campian,Maria E, AU - Reesink,Herre J, AU - Surie,Sulaiman, AU - Bouma,Berto J, AU - Groenink,Maarten, AU - Klemens,Christine A, AU - Beekman,Leander, AU - Remme,Carol A, AU - Bresser,Paul, AU - Tan,Hanno L, PY - 2010/07/20/received PY - 2010/07/20/revised PY - 2010/08/24/accepted PY - 2011/2/19/entrez PY - 2011/2/19/pubmed PY - 2013/8/8/medline SP - 921 EP - 8 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 57 IS - 8 N2 - OBJECTIVES: We sought to study whether patients with right ventricular failure (RVF) secondary to chronic thromboembolic pulmonary hypertension (CTEPH) have reduced left ventricular (LV) mass, and whether LV mass reduction is caused by atrophy. BACKGROUND: The LV in patients with CTEPH is underfilled (unloaded). LV unloading may cause atrophic remodeling that is associated with diastolic and systolic dysfunction. METHODS: We studied LV mass using cardiac magnetic resonance imaging (MRI) in 36 consecutive CTEPH patients (before/after pulmonary endarterectomy [PEA]) and 11 healthy volunteers selected to match age and sex of patients. We studied whether LV atrophy is present in monocrotaline (MCT)-injected rats with RVF or controls by measuring myocyte dimensions and performing in situ hybridization. RESULTS: At baseline, CTEPH patients with RVF had significantly lower LV free wall mass indexes than patients without RVF (35 ± 6 g/m(2) vs. 44 ± 7 g/m(2), p = 0.007) or volunteers (42 ± 6 g/m(2), p = 0.006). After PEA, LV free wall mass index increased (from 38 ± 6 g/m(2) to 44 ± 9 g/m(2), p = 0.001), as right ventricular (RV) ejection fraction improved (from 31 ± 8% to 56 ± 12%, p < 0.001). Compared with controls, rats with RVF had reduced LV free wall mass and smaller LV free wall myocytes. Expression of atrial natriuretic peptide was higher, whereas that of α-myosin heavy chain and sarcoplasmic reticulum calcium ATPase-2 were lower in RVF than in controls, both in RV and LV. CONCLUSIONS: RVF in patients with CTEPH is associated with reversible reduction in LV free wall mass. In a rat model of RVF, myocyte shrinkage due to atrophic remodeling contributed to reduction in LV free wall mass. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/21329838/Right_ventricular_failure_following_chronic_pressure_overload_is_associated_with_reduction_in_left_ventricular_mass:_evidence_for_atrophic_remodeling_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(10)04818-7 DB - PRIME DP - Unbound Medicine ER -