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Right ventricular failure complicating heart failure: Pathophysiology, significance, and management strategies

  • Epidemiology and Pathophysiology of Heart Failure
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Abstract

Right heart failure most commonly results from the complication of left heart failure (systolic or nonsystolic dysfunction) or pulmonary hypertension. Over the past decade, greater attention has been paid to the role of right ventricular failure in the morbidity and mortality associated with cardiomyopathy and pulmonary hypertension. The right ventricle is distinct from the left ventricle not only in its spatial localization, but also in its response to increased afterload and signaling mechanisms. This article discusses the role of right ventricular failure in the setting of heart failure as well as the clinical diagnosis and management of right ventricular failure.

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References and Recommended Reading

  1. Barst RJ, McGoon M, Torbicki A, et al.:Diagnosis and differential assessment of pulmonary arterial hypertension.J Am Coll Cardiol 2004,43(12 Suppl S):40S-47S.

    Article  PubMed  Google Scholar 

  2. Rich S:Pulmonary hypertension. InBraunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. Edited by Braunweld E, Zipes DP, Libby P, Bonow RO. Philadelphia: WB Saunders; 2001.

    Google Scholar 

  3. Of major importance Voelkel NF, Quaife RA, Leinwand LA, et al.:Right ventricular function and failure: report of a National Heart, Lung, and Blood Institute working group on cellular and molecular mechanisms of right heart failure.Circulation 2006,114:1883–1891. Outlines the NIH initiative to better understand RV function and is an excellent review of RV function/failure.

    Article  PubMed  Google Scholar 

  4. Klotz S, Naka Y, Oz MC, Burkhoff D:Biventricular assist device-induced right ventricular reverse structural and functional remodeling.J Heart Lung Transplant 2005,24:1195–1201.

    Article  PubMed  Google Scholar 

  5. Klotz S, Barbone A, Reiken S, et al.:Left ventricular assist device support normalizes left and right ventricular betaadrenergic pathway properties.J Am Coll Cardiol 2005,45:668–676.

    Article  PubMed  Google Scholar 

  6. Mandarino WA, Winowich S, Gasior TA, et al.:Assessment of timing right ventricular assist device withdrawal using left ventricular assist device filling characteristics.Asaio J 1997,43:M801-M805.

    PubMed  CAS  Google Scholar 

  7. Mandarino WA, Winowich S, Gorcsan J 3rd, et al.:Right ventricular performance and left ventricular assist device filling.Ann Thorac Surg 1997,63:1044–1049.

    Article  PubMed  CAS  Google Scholar 

  8. Iskandrian AS, Hakki AH, Ren JF, et al.:Correlation among right ventricular preload, afterload and ejection fraction in mitral valve disease: radionuclide, echocardiographic and hemodynamic evaluation.J Am Coll Cardiol 1984,3:1403–1411.

    Article  PubMed  CAS  Google Scholar 

  9. Szabo G, Soos P, Bahrle S, et al.:Adaptation of the right ventricle to an increased afterload in the chronically volume overloaded heart.Ann Thorac Surg 2006,82:989–995.

    Article  PubMed  Google Scholar 

  10. Szabo G, Sebening C, Hagl C, et al.:Right ventricular function after brain death: response to an increased afterload.Eur J Cardiothorac Surg 1998,13:449–458; discussion 458-449.

    Article  PubMed  CAS  Google Scholar 

  11. Mebazaa A, Karpati P, Renaud E, Algotsson L:Acute right ventricular failure-from pathophysiology to new treatments.Intensive Care Med 2004,30:185–196.

    Article  PubMed  Google Scholar 

  12. Moffatt-Bruce SD, Jamieson WR:Long-term performance of prostheses in mitral valve replacement.J Cardiovasc Surg (Torino) 2004,45:427–447.

    CAS  Google Scholar 

  13. Cavusoglu Y, Ata N, Timuralp B, et al.:Noncompaction of the ventricular myocardium: report of two cases with bicuspid aortic valve demonstrating poor prognosis and with prominent right ventricular involvement.Echocardiography 2003,20:379–383.

    Article  PubMed  Google Scholar 

  14. Enriquez-Sarano M, Rossi A, Seward JB, et al.:Determinants of pulmonary hypertension in left ventricular dysfunction.J Am Coll Cardiol 1997,29:153–159.

    Article  PubMed  CAS  Google Scholar 

  15. Zanchetti A, Stella A:Neural control of renin release.Clin Sci Mol Med 1975,2(Suppl):215s-223s.

    CAS  Google Scholar 

  16. Penna C, Rastaldo R, Mancardi D, et al.:Effect of endothelins on the cardiovascular system.J Cardiovasc Med (Hagerstown) 2006,7:645–652.

    Google Scholar 

  17. Brunner F, Bras-Silva C, Cerdeira AS, Leite-Moreira AF:Cardiovascular endothelins: essential regulators of cardiovascular homeostasis.Pharmacol Ther 2006,111:508–531.

    PubMed  CAS  Google Scholar 

  18. Motte S, McEntee K, Naeije R:Endothelin receptor antagonists.Pharmacol Ther 2006,110:386–414.

    Article  PubMed  CAS  Google Scholar 

  19. Passino C, Maria Sironi A, Favilli B, et al.:Right heart overload contributes to cardiac natriuretic hormone elevation in patients with heart failure.Int J Cardiol 2005,104:39–45.

    Article  PubMed  Google Scholar 

  20. Bergler-Klein J, Pacher R, Berger R, et al.:Neurohumoral and hemodynamic effects of the selective endothelin antagonist darusentan in advanced chronic heart failure.J Heart Lung Transplant 2004,23:20–27.

    Article  PubMed  Google Scholar 

  21. Laviolle B, Pape D, Turlin B, Bellissant E:Direct effects of 3 combinations of enalapril, metoprolol, and spironolactone on cardiac remodeling in dilated cardiomyopathic hamsters.J Card Fail 2006,12:752–758.

    Article  PubMed  CAS  Google Scholar 

  22. Lewis GD, Semigran MJ:The emerging role for type 5 phosphodiesterase inhibition in heart failure.Curr Heart Fail Rep 2006,3:123–128.

    Article  PubMed  CAS  Google Scholar 

  23. Ibrahim OA, Dunlap ME:Combination pharmacologic therapies for heart failure: what next after angiotensin-converting enzyme inhibitors and beta-blockers? Curr Heart Fail Rep 2005,2:89–93.

    Article  PubMed  CAS  Google Scholar 

  24. Uriel N, Torre-Amione G, Milo O, et al.:Echocardiographic ejection fraction in patients with acute heart failure: correlations with hemodynamic, clinical, and neurohormonal measures and short-term outcome.Eur J Heart Fail 2005,7:815–819.

    Article  PubMed  Google Scholar 

  25. Silver MA:The natriuretic peptide system: kidney and cardiovascular effects.Curr Opin Nephrol Hypertens 2006,15:14–21.

    PubMed  CAS  Google Scholar 

  26. Givertz MM, Hare JM, Loh E, et al.:Effect of bolus milrinone on hemodynamic variables and pulmonary vascular resistance in patients with severe left ventricular dysfunction: a rapid test for reversibility of pulmonary hypertension.J Am Coll Cardiol 1996,28:1775–1780.

    Article  PubMed  CAS  Google Scholar 

  27. Aranda JM Jr, Schofield RS, Pauly DF, et al.:Comparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: a prospective, randomized trial.Am Heart J 2003,145:324–329.

    Article  PubMed  CAS  Google Scholar 

  28. Zewail AM, Nawar M, Vrtovec B, et al.:Intravenous milrinone in treatment of advanced congestive heart failure.Tex Heart Inst J 2003,30:109–113.

    PubMed  Google Scholar 

  29. Young R, Worthley LI:Current concepts in the management of heart failure.Crit Care Resusc 2004,6:31–53.

    PubMed  CAS  Google Scholar 

  30. Young JB, Moen EK:Outpatient parenteral inotropic therapy for advanced heart failure.J Heart Lung Transplant 2000,19(8 Suppl):S49-S57.

    Article  PubMed  CAS  Google Scholar 

  31. Cleland JG, Freemantle N, Coletta AP, Clark AL: Clinical trials update from the American Heart Association:REPAIR-AMI, ASTAMI, JELIS, MEGA, REVIVE-II, SURVIVE, and PROACTIVE.Eur J Heart Fail 2006,8:105–110.

    Article  PubMed  CAS  Google Scholar 

  32. Parissis JT, Paraskevaidis I, Bistola V, et al.:Effects of levosimendan on right ventricular function in patients with advanced heart failure.Am J Cardiol 2006,98:1489–1492.

    Article  PubMed  CAS  Google Scholar 

  33. Slawsky MT, Colucci WS, Gottlieb SS, et al.:Acute hemodynamic and clinical effects of levosimendan in patients with severe heart failure. Study Investigators.Circulation 2000,102:2222–2227.

    PubMed  CAS  Google Scholar 

  34. Leather HA, Ver Eycken K, Segers P, et al.:Effects of levosimendan on right ventricular function and ventriculovascular coupling in open chest pigs.Crit Care Med 2003,31:2339–2343.

    Article  PubMed  CAS  Google Scholar 

  35. Marvin A, Konstam JEU:Right heart failure. InCongestive Heart Failure. Edited by Hosenpud J, Greenberg BH. Philadelphia: Lippincott Williams and Wilkins; 2000.

    Google Scholar 

  36. Isner JM, Fisher GP, Del Negro AA, Borer JS:Right ventricular infarction with hemodynamic decompensation due to transient loss of active atrial augmentation: successful treatment with atrial pacing.Am Heart J 1981,102:792–794.

    Article  PubMed  CAS  Google Scholar 

  37. Eichhorn EJ, Konstam MA, Weiland DS, et al.:Differential effects of milrinone and dobutamine on right ventricular preload, afterload and systolic performance in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.Am J Cardiol 1987,60:1329–1333.

    Article  PubMed  CAS  Google Scholar 

  38. Juilliere Y, Feldmann L, Perrin O, et al.:Beneficial cumulative role of both nitroglycerin and dobutamine on right ventricular systolic function in congestive heart failure patients awaiting heart transplantation.Int J Cardiol 1995,52:17–22.

    Article  PubMed  CAS  Google Scholar 

  39. Konstam MA, Cohen SR, Salem DN, et al.:Effect of amrinone on right ventricular function: predominance of afterload reduction.Circulation 1986,74:359–366.

    PubMed  CAS  Google Scholar 

  40. Alp S, Skrygan M, Schmidt WE, Bastian A:Sildenafil improves hemodynamic parameters in COPD-an investigation of six patients.Pulm Pharmacol Ther 2006,19:386–390.

    Article  PubMed  CAS  Google Scholar 

  41. Ashutosh K, Mead G, Dunsky M:Early effects of oxygen administration and prognosis in chronic obstructive pulmonary disease and cor pulmonale.Am Rev Respir Dis 1993,127:399–404.

    Google Scholar 

  42. Minai OA, Arroliga AC:Long-term results after addition of sildenafil in idiopathic PAH patients on bosentan.South Med J 2006,99:880–883.

    Article  PubMed  Google Scholar 

  43. Tapson VF, Gomberg-Maitland M, McLaughlin VV, et al.:Safety and efficacy of IV treprostinil for pulmonary arterial hypertension: a prospective, multicenter, open-label, 12-week trial.Chest 2006,129:683–688.

    Article  PubMed  CAS  Google Scholar 

  44. Barst RJ:Medical therapy of pulmonary hypertension. An overview of treatment and goals.Clin Chest Med 2001,22:509–515, ix.

    Article  PubMed  CAS  Google Scholar 

  45. Barst RJ, Rubin LJ, Long WA, et al.:A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. The Primary Pulmonary Hypertension Study Group.N Engl J Med 1996,334:296–302.

    Article  PubMed  CAS  Google Scholar 

  46. Steiner MK, Preston IR, Klinger JR, et al.:Conversion to bosentan from prostacyclin infusion therapy in pulmonary arterial hypertension: a pilot study.Chest 2006,130:1471–1480.

    Article  PubMed  CAS  Google Scholar 

  47. Channick RN, Olschewski H, Seeger W, et al.:Safety and efficacy of inhaled treprostinil as add-on therapy to bosentan in pulmonary arterial hypertension.J Am Coll Cardiol 2006,48:1433–1437.

    Article  PubMed  CAS  Google Scholar 

  48. Of major importance Forfia PR, Fisher MR, Mathai SC, et al.:Tricuspid annular displacement predicts survival in PAH.Am J Respir Crit Care Med 2006,174:1034–1041. TAPSE is a noninvasive surrogate for RV function that predicts mortality in patients with PAH.

    Article  PubMed  Google Scholar 

  49. Girgis RE, Mathai SC, Krishnan JA, et al.:Long-term outcome of bosentan treatment in idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with the scleroderma spectrum of diseases.J Heart Lung Transplant 2005,24:1626–1631.

    Article  PubMed  Google Scholar 

  50. Lewis GD, Lachmann J, Camuso J, et al.:Sildenafil improves exercise hemodynamics and oxygen uptake in patients with systolic heart failure.Circulation. Jan 2 2007,115(1):59–66.

    Article  PubMed  CAS  Google Scholar 

  51. Of importance Alaeddini J, Uber PA, Park MH, et al.:Efficacy and safety of sildenafil in the evaluation of pulmonary hypertension in severe heart failure.Am J Cardiol 2004,94:1475–1477. Demonstrates the utility of PDE5 inhibition in the treatment of PH associated with heart failure.

    Article  PubMed  CAS  Google Scholar 

  52. Sablotzki A, Czeslick E, Schubert S, et al.:Iloprost improves hemodynamics in patients with severe chronic cardiac failure and secondary pulmonary hypertension.Can J Anaesth 2002,49:1076–1080.

    Article  PubMed  Google Scholar 

  53. Montalescot G, Drobinski G, Meurin P, et al.:Effects of prostacyclin on the pulmonary vascular tone and cardiac contractility of patients with pulmonary hypertension secondary to end-stage heart failure.Am J Cardiol 1998,82:749–755.

    Article  PubMed  CAS  Google Scholar 

  54. Packer M, McMurray J, Massie BM, et al.:Clinical effects of endothelin receptor antagonism with bosentan in patients with severe chronic heart failure: results of a pilot study.J Card Fail 2005,11:12–20.

    Article  PubMed  CAS  Google Scholar 

  55. Kalra PR, Moon JC, Coats AJ:Do results of the ENABLE (Endothelin Antagonist Bosentan for Lowering Cardiac Events in Heart Failure) study spell the end for non-selective endothelin antagonism in heart failure? Int J Cardiol 2002,85:195–197.

    Article  PubMed  Google Scholar 

  56. Wlodarska EK, Wozniak O, Konka M, et al.:Thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy.Europace 2006,8:596–600.

    Article  PubMed  Google Scholar 

  57. Ramakrishna G, Sprung J, Ravi BS, et al.:Impact of pulmonary hypertension on the outcomes of noncardiac surgery: predictors of perioperative morbidity and mortality.J Am Coll Cardiol 2005,45:1691–1699.

    Article  PubMed  Google Scholar 

  58. Naeije R, Vizza D:Current perspectives modern hemodynamic evaluation of the pulmonary circulation. Application to pulmonary arterial hypertension and embolic pulmonary hypertension.Ital Heart J 2005,6:784–788.

    PubMed  Google Scholar 

  59. Via G, Braschi A:Pathophysiology of severe pulmonary hypertension in the critically ill patient.Minerva Anestesiol 2004,70:233–237.

    PubMed  CAS  Google Scholar 

  60. Dell’Italia LJ, Starling MR, O’Rourke RA:Physical examination for exclusion of hemodynamically important right ventricular infarction.Ann Intern Med 1983,99:608–611.

    PubMed  CAS  Google Scholar 

  61. Natale ME, Pina IL:Evaluation of pulmonary hypertension in heart transplant candidates.Curr Opin Cardiol 2003,18:136–140.

    Article  PubMed  Google Scholar 

  62. Hemnes A, Champion H:Diagnosis and management of secondary pulmonary hypertension. InTreatment of Advanced Heart Failure. Edited by Baughman K, Baumgartner W. New York: Taylor & Francis; 2006:247–258.

    Google Scholar 

  63. Quaife RA, Chen MY, Lynch D, et al.:Importance of right ventricular end-systolic regional wall stress in idiopathic pulmonary arterial hypertension: a new method for estimation of right ventricular wall stress.Eur J Med Res 2006,11:214–220.

    PubMed  Google Scholar 

  64. Kjaer A, Lebech AM, Gerstoft J, et al.:Right ventricular volume and mass determined by cine magnetic resonance imaging in HIV patients with possible right ventricular dysfunction.Angiology 2006,57:341–346.

    Article  PubMed  Google Scholar 

  65. Lankhaar JW, Westerhof N, Faes TJ, et al.:Quantification of right ventricular afterload in patients with and without pulmonary hypertension.Am J Physiol Heart Circ Physiol 2006,291:H1731-H1737.

    Article  PubMed  CAS  Google Scholar 

  66. Tandri H, Saranathan M, Rodriguez ER, et al.:Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed-enhancement magnetic resonance imaging.J Am Coll Cardiol 2005,45:98–103.

    Article  PubMed  Google Scholar 

  67. Tuller D, Steiner M, Wahl A, et al.:Systolic right ventricular function assessment by pulsed wave tissue Doppler imaging of the tricuspid annulus.Swiss Med Wkly 2005,135:461–468.

    PubMed  Google Scholar 

  68. Vonk-Noordegraaf A, Marcus JT, Holverda S, et al.:Early changes of cardiac structure and function in COPD patients with mild hypoxemia.Chest 2005,127:1898–1903.

    Article  PubMed  Google Scholar 

  69. Merten M, Meinertz T, Willems S, Heinemann A:Arrhythmogenic right ventricular cardiomyopathy with left ventricular involvement and aortic dissection.Pacing Clin Electrophysiol 2004,27:408–411.

    Article  PubMed  Google Scholar 

  70. Kuehne T, Yilmaz S, Steendijk P, et al.:Magnetic resonance imaging analysis of right ventricular pressure-volume loops: in vivo validation and clinical application in patients with pulmonary hypertension.Circulation 2004,110:2010–2016.

    Article  PubMed  Google Scholar 

  71. Quaife RA, Lynch D, Badesch DB, et al.:Right ventricular phenotypic characteristics in subjects with primary pulmonary hypertension or idiopathic dilated cardiomyopathy.J Card Fail 1999,5:46–54.

    Article  PubMed  CAS  Google Scholar 

  72. Marcus JT, Vonk Noordegraaf A, De Vries PM, et al.:MRI evaluation of right ventricular pressure overload in chronic obstructive pulmonary disease.J Magn Reson Imaging 1998,8:999–1005.

    Article  PubMed  CAS  Google Scholar 

  73. Moulton MJ, Creswell LL, Ungacta FF, et al.:Magnetic resonance imaging provides evidence for remodeling of the right ventricle after single-lung transplantation for pulmonary hypertension.Circulation 1996,94(9 Suppl): II312-II319.

    PubMed  CAS  Google Scholar 

  74. Sugiura T, Suzuki S, Hussein MH, et al.:The Tei index permits evaluation of cardiopulmonary function during inhaled nitric oxide therapy in the hypoxic newborn piglet.Biol Neonate 2004,86:176–182.

    Article  PubMed  CAS  Google Scholar 

  75. Daniels LB, Krummen DE, Blanchard DG:Echocardiography in pulmonary vascular disease.Cardiol Clin 2004,22:383–399, vi.

    Article  PubMed  Google Scholar 

  76. Galderisi M, Severino S, Cicala S, Caso P:The usefulness of pulsed tissue Doppler for the clinical assessment of right ventricular function.Ital Heart J 2002,3:241–247.

    PubMed  Google Scholar 

  77. Yeo TC, Dujardin KS, Tei C, et al.:Value of a Doppler-derived index combining systolic and diastolic time intervals in predicting outcome in primary pulmonary hypertension.Am J Cardiol 1998,81:1157–1161.

    Article  PubMed  CAS  Google Scholar 

  78. Tei C, Dujardin KS, Hodge DO, et al.:Doppler echocardiographic index for assessment of global right ventricular function.J Am Soc Echocardiogr 1996,9:838–847.

    Article  PubMed  CAS  Google Scholar 

  79. Siqueira-Filho AG, Cunha CL, Tajik AJ, et al.:M-mode and two-dimensional echocardiographic features in cardiac amyloidosis.Circulation 1981,63:188–196.

    PubMed  CAS  Google Scholar 

  80. Teshima K, Asano K, Iwanaga K, et al.:Evaluation of right ventricular Tei index (index of myocardial performance) in healthy dogs and dogs with tricuspid regurgitation.J Vet Med Sci 2006,68:1307–1313.

    Article  PubMed  Google Scholar 

  81. Grignola JC, Gines F, Guzzo D:Comparison of the Tei index with invasive measurements of right ventricular function.Int J Cardiol 2006,113:25–33.

    Article  PubMed  Google Scholar 

  82. Tobinick E, Schelbert HR, Henning H, et al.:Right ventricular ejection fraction in patients with acute anterior and inferior myocardial infarction assessed by radionuclide angiography.Circulation 1978,57:1078–1084.

    PubMed  CAS  Google Scholar 

  83. Park OY, Ahn Y, Park WS, et al.:Rapid progression from hypertrophic cardiomyopathy to heart failure in a patient with Becker’s muscular dystrophy.Eur J Heart Fail 2005,7:684–688.

    Article  PubMed  Google Scholar 

  84. Alaeddini J, Uber P, Park MH, et al.:Sildenafil and assessment of pulmonary arterial reactivity in heart failure.Congest Heart Fail 2003,9:176–178.

    Article  PubMed  Google Scholar 

  85. O’Dell KM, Kalus JS, Kucukarslan S, Czerska B:Nesiritide for secondary pulmonary hypertension in patients with end-stage heart failure.Am J Health Syst Pharm 2005,62:606–609.

    PubMed  CAS  Google Scholar 

  86. Rubin LJ, Rich S:Medical management. In:Primary Pulmonary Hypertension. New York: Marcel Dekker; 1997:271–286.

    Google Scholar 

  87. Cargill RI, Lipworth BJ.Lisinopril attenuates acute hypoxic pulmonary vasoconstriction in humans,Chest 1996,109:424–429.

    Article  PubMed  CAS  Google Scholar 

  88. Buss SJ, Backs J, Kreusser MM, et al.:Spironolactone preserves cardiac norepinephrine reuptake in salt-sensitive Dahl rats.Endocrinology 2006,147:2526–2534.

    Article  PubMed  CAS  Google Scholar 

  89. Anand I, McMurray J, Cohn JN, et al.:Long-term effects of darusentan on left-ventricular remodelling and clinical outcomes in the EndothelinA Receptor Antagonist Trial in Heart Failure (EARTH): randomised, double-blind, placebo-controlled trial.Lancet 2004,364:347–354.

    Article  PubMed  CAS  Google Scholar 

  90. Lip GY:Darusentan (Abbott Laboratories).I Drugs 2001,4:1284–1292.

    PubMed  CAS  Google Scholar 

  91. Teerlink JR:Overview of randomized clinical trials in acute heart failure syndrome.Am J Cardiol 2005,96:59G-67G.

    Article  PubMed  CAS  Google Scholar 

  92. Cheng JW:Tezosentan in the management of decompensated heart failure.Cardiol Rev 2005,13:28–34.

    PubMed  Google Scholar 

  93. Cotter G, Kaluski E, Stangl K, et al.:The hemodynamic and neurobormonal effects of low doses of tezosentan (an endothelin A/B receptor antagonist) in patients with acute heart failure.Eur J Heart Fail 2004,6:601–609.

    Article  PubMed  CAS  Google Scholar 

  94. Sharma M, Teerlink JR:A rational approach for the treatment of acute heart failure: current strategies and future options.Curr Opin Cardiol 2004,19:254–263.

    Article  PubMed  Google Scholar 

  95. Tovar JM, Gums JG:Tezosentan in the treatment of acute heart failure.Ann Pharmacother 2003,37:1877–1883.

    Article  PubMed  CAS  Google Scholar 

  96. Lewis GD, Witzke C, Colon-Hernandez P, et al.:Sildenafil improves coronary artery patency in a canine model of platelet-mediated cyclic coronary occlusion after thrombolysis.J Am Coll Cardiol 2006,47:1471–1477.

    Article  PubMed  CAS  Google Scholar 

  97. Semigran MJ:Type 5 phosphodiesterase inhibition: the focus shifts to the heart.Circulation 2005,112:2589–2591.

    Article  PubMed  Google Scholar 

  98. Konstam MA, Weiland DS, Conlon TP, et al.:Hemodynamic correlates of left ventricular versus right ventricular radionuclide volumetric responses to vasodilator therapy in congestive heart failure secondary to ischemic or dilated cardiomyopathy.Am J Cardiol 1987,59:1131–1137.

    Article  PubMed  CAS  Google Scholar 

  99. Murdoch CE, Zhang M, Cave AC, Shah AM:NADPH oxidase-dependent redox signaling in cardiac hypertrophy, remodeling and failure.Cardiovasc Res 2006,71:208–215.

    Article  PubMed  CAS  Google Scholar 

  100. Ago T, Sadoshima J:Thioredoxin and ventricular remodeling.J Mol Cell Cardiol 2006,41:762–773.

    Article  PubMed  CAS  Google Scholar 

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  1. Division of Cardiology, Department of Medicine, Johns Hopkins University, 720 Rutland Avenue, Ross 850, 21205, Baltimore, MD, USA

    Hunter C. Champion MD, PhD

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  1. Mobusher Mahmud MD
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Mahmud, M., Champion, H.C. Right ventricular failure complicating heart failure: Pathophysiology, significance, and management strategies. Curr Cardiol Rep 9, 200–208 (2007). https://doi.org/10.1007/BF02938351

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