Pulmonary disease and right ventricular function

Abstract

Respiratory diseases have become major players in mortality and morbidity charts and their influence on cardiac function has brought them in research focus, especially when investigating their role on the pathobiology of the less well understood right ventricle. By insulting pulmonary vasculature it leads to micro and macrovessel injury which results in pulmonary hypertension, increased right ventricle afterload along with its consequences- right ventricle hypertrophy and dilation. From the initial physical stimuli of hypoxia, translated by the vessel wall cells into a biological response of vasoconstriction and remodeling, pulmonary hypertension develops in a process modulated by the endothelium and many other epigenetic factors. Pulmonary hypertension is rarely severe when associated purely with chronic lung disease but carries a poor prognosis nevertheless, especially when associating right ventricle dysfunction. The primary diagnostic tools remain the echocardiography parameters generally used in all forms of the disorder and invasive procedures are infrequently necessary for evaluation. Unfortunately, this class of pulmonary hypertension shares much of the prognosis and complications with other groups of the, disorder, but less of the therapeutic arsenal which has become more recently available in the latter.