دانلود کتاب the RIGHT HEART.

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Foreword
Preface
Contents
Part I: Physiology, Pathology and Pathobiology
1: Function of the Right Ventricle
From Early to Recent Ideas on RV Function
Physiology of RV Contraction and Relaxation
Myocyte Contraction
Myocyte Relaxation
RV Contraction, Ejection, and RV Pressure Curve
Influence of LV Contraction on RV Ejection
Description of RV Function
The Ventricular Pressure-Volume Loop
Systolic Properties: The End-Systolic Pressure-Volume Relation
Considerations for the Application of RV ESPVR and Ees
The Cardiopulmonary System
Diastolic Properties: The End-Diastolic Pressure-Volume Relation
Single-Beat Analysis of Ees and Eed
Regulation of RV Function
Volume Response: The Frank-Starling Mechanism
Afterload Response: Sympathetic Activation
Conclusions
References
2: Right Ventricular Pathobiology
Introduction
RV Functional Decline and Recovery Are Highly Variable
RV Failure Is in Part Independent of Pulmonary Hemodynamics
Pathology of RV Failure
Molecular Mechanisms of RV Failure
Ischemia and Angiogenesis
Neurohormonal Activation in RV Failure
Right Ventricular Metabolism and Mitochondrial Function
Sex Hormones
Other Causes of RV Failure
Genetics of RV Failure
BMPR2
RV Failure in Non-group 1 PH
Future Directions
References
3: Experimental Models
Introduction
MCT-Induced PAH
MCT Plus Pneumonectomy
Hypoxia-Induced PH
Chronic Hypoxia in Mice
Chronic Hypoxia in Rats
Sugen 5416 Plus Chronic Hypoxia in Rats
Sugen 5416 Plus Chronic Hypoxia in Mice
Schistosomiasis
PH Due to Left-Heart Disease
Myocardial Infarction (MI)
Transverse Aortic Constriction (TAC)
Metabolic Syndrome
Chronic Thromboembolic PH (CTEPH)
Pulmonary Artery Banding (PAB)
Other Models
Smoke-Induced PH
Intermittent Hypoxia
Lung Cancer-Associated PH
Summary
References
4: Mechanical and Functional Interdependence Between the RV and LV
Introduction
Physiology of RV-LV Interactions
RV-LV Interactions When the RV Is Hypertensive
Mechanical-Molecular RV-LV Interactions in RV Hypertension
RV-LV Interactions at the Septal Hinge-Point Regions
Therapeutic Targeting of Molecular-Tissue RV-LV Interactions in RV Hypertension
RV-LV Interactions in Congenital Heart Disease
Summary
References
Part II: Imaging the Right Heart
5: MRI of the Right Ventricle in Normal Subjects and Those with Pulmonary Hypertension
Introduction
Measuring Ventricular Volumes, Mass and Global Function
Measuring Regional Right Ventricular Function: Myocardial Tagging and Strain Mapping
CMR-Guided Right-Heart Catheterisation
Defining Normal Values for Right Ventricular Mass and Volume
Factors Affecting Normal Values: Scaling Right Ventricular Size and Function for Body Size
Ageing and the Right Ventricle
Sex
Race
Physical Activity (in the Non-athlete)
Obesity
Normative Equations for RV Variables
Role of CMR in the Diagnosis and Management of Patients with Pulmonary Hypertension
Diagnosis of Pulmonary Hypertension
Effects of Pulmonary Hypertension on Cardiac Structure: Measurements by CMR
RV (and LV) Mass/Volumes/Damage
Effects of Pulmonary Hypertension on Cardiac Function: Measurements by CMR
RV-PA Coupling
Global vs. Regional Cardiac Function in PH
Myocardial Perfusion
Treatment of Pulmonary Hypertension: Efficacy Measured by CMR
Conclusion
References
6: Right Ventricular Structure and Function During Exercise
Introduction: Why Is Right Ventricular Function Important During Exercise?
Physiology of the RV and Pulmonary Circulation and Its Relevance to Exercise
Exercise Causes a Disproportionate Increase in RV Pressures, Wall Stress and Work
How Can RV Function Be Assessed During Exercise?
Can the Healthy RV Cope with the Increased Pulmonary Vascular Load of Exercise?
Clinical Settings in Which the Assessment of RV Function During Exercise May Be Important
Athletes
Chronic Pulmonary Disease
Pulmonary Vascular Pathology
Heart Failure
Valvular Heart Disease
Congenital Heart Disease
Can Pulmonary Vasodilators Improve Exercise Tolerance?
Conclusions
References
7: Echocardiography of the Right Heart
Introduction
Measurement of the Pulmonary Pressures and Cardiac Output
Accuracy of Echocardiographic Measurements of the Pulmonary Circulation
RV Systolic Function and RV-Arterial Coupling
Echocardiographic Indices of RV Systolic Function
RV Systolic Function Assessed by 3D Echo and 3D Right Ventricular Ejection Fraction
RV Dimensions, Remodeling, and Diastolic Function
RV Dyssynchrony
Conclusions
References
Part III: Causes of Right Heart Dysfunction
8: Volume Overload and the Right Heart
Introduction
Overview of RV Volume Overload
Anatomic and Functional Adaptation to RV Volume Overload
Cellular and Molecular Adaptation to RV Volume Overload
Clinical Course and Management of RV Volume Overload
Specific Etiologies of RV Volume Overload
Tricuspid Regurgitation
Pulmonary Regurgitation
ASD/PAPVR
Conclusions
References
9: Right Ventricular Response to Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension
Introduction
RV Responses to Load
RV Remodeling in Pulmonary Arterial Hypertension of Congenital Heart Disease
RV Remodeling in Chronic Thromboembolic Hypertension
Assessment of RV Contractility
Echocardiography
Cardiac Magnetic Resonance Imaging
Pressure-Volume Loops
End-Systolic Elastance as a Measure of RV Contractility
Pulmonary Arterial Elastance as a Measure of Afterload
Preload Recruitable Stroke Work as a Measure of Contractility
Alterations in RV Contractility and Ventricular-Arterial Coupling in PAH and CTEPH
Pressure-Volume Loop Evaluation of RV-Pulmonary Arterial Coupling
RV-PA Coupling Predicts Outcomes in PAH
Echocardiography Evaluation of RV-Arterial Coupling
cMRI Evaluation of RV-PA Coupling
RV-PA Coupling and Disease
RV-PA Coupling in Idiopathic PAH and Systemic Sclerosis-Associated PAH
RV-PA Coupling in Congenital Heart Disease
RV-PA Coupling in CTEPH
Sex Differences in RV-PA Coupling
RV Reserve
Mechanisms Underlying Maladaptive RV Adaptation in PAH
Macro- and Microvascular RV Ischemia
Metabolic Shifts in the RV Myocardium
Neurohormonal Activation
Metabolic Syndrome and RV Remodeling
RV Diastolic Dysfunction in PAH and CTEPH
Conclusion
References
10: Left-Heart Failure and Its Effects on the Right Heart
Introduction
Causes of Right-Heart Dysfunction in HFrEF Patients
Causes of Right-Heart Dysfunction in HFpEF Patients
Gaps in Evidence and Perspectives
Conclusions
References
11: Cor Pulmonale
Introduction
Physiological Reminders
Diagnosis of Cor Pulmonale
Treatment of Cor Pulmonale
References
12: High Altitude and the Right Ventricle
Introduction
Definitions
Altitude as a Cause of Increased RV Afterload
Does Hypoxic Exposure Exert Negative Inotropic Effects?
The Right Ventricle During Hypoxic Exercise
High Altitude-Induced Right-Heart Failure
Perspective
References
13: The Right Ventricle in Congenital Heart Diseases
Introduction
Lesions Affecting Preload
Atrial Septal Defect
Tetralogy of Fallot
Historical Perspective
Pulmonary Incompetence
RV Motion: A Gradient from Base to Apex
RVOT Akinesia and Dyskinesia
Dyssynchrony and RV-LV Interaction
Restrictive RV Physiology
Outcome and Risk Factors
The Systemic RV
The Systemic RV in a Biventricular Circulation: ccTGA and TGA-Senning/Mustard
TGA and Atrial Switch
RV Dysfunction in Systemic RV
Tricuspid Insufficiency
Dyssynchrony
Response to Exercise/Stress
Treatment Options
Pulmonary Artery Banding and Double Switch
The Systemic RV in Hypoplastic Left-Heart Syndrome
The RV in PAH Associated with CHD
Summary
References
14: Pulmonary Embolism
Introduction
Mechanisms Regulating Thrombosis
Epidemiology of Venous Thromboembolism
Pulmonary Vasculature
Pulmonary Arterial System Network and the Right Ventricle
Acute Pulmonary Embolism, Right Ventricular Architecture, and Myocardial Mechanics
Diagnosis and Assessment of Right Ventricular Function in Acute Pulmonary Embolism
New Frontiers in the Assessment of Right Ventricular Function in Acute Pulmonary Embolism
After Acute Pulmonary Embolism Diagnosis
Risk Assessment
Imaging
Prognosis
Groups at Increased Risk of Recurrence (High at >8%/Year)
Duration of Anticoagulation
Chronic Pulmonary Embolism
Conclusion
References
15: Right Ventricular Cardiomyopathies
Arrhythmogenic Cardiomyopathy
Historical Notes and First Clinical Descriptions
Epidemiology
Pathological Findings
Genetic Background
Plakophilin 2 (PKP-2)
Desmoplakin (DSP)
Desmoglein 2 (DSG-2)
Desmocollin 2 (DSC-2)
Plakoglobin (JUP)
α-T-Catenin (CTNNA3)
Cadherin-2 (CDH2)
Laminin (LMNA)
Desmin (DES)
Transmembrane Protein 43 (TMEM-43)
Titin (TTN)
Filamin C (FLNC)
Ryanodine Receptor 2 (RYR2)
Nav1.5 (SCNA5)
Phospholamban (PLN)
Clinical Features and Natural History
Sports Activity and Arrhythmogenic Cardiomyopathy
Disease Diagnosis
Diagnostic Tools in AC
Personal and Familial Anamnesis
Twelve-Lead Electrocardiogram (ECG)
Ventricular Arrhythmia (VA) Detection
Two-Dimensional Echocardiography
Advanced Echo Modalities
Cardiac Magnetic Resonance
Endomyocardial Biopsy
Arrhythmogenic Left Ventricular Cardiomyopathy
Therapeutic Strategies in AC
Physical Restriction
Drug Therapy
Beta-Blockers
Antiarrhythmic Drugs
Heart Failure Drugs
New Drugs
Catheter Ablation
ICD Implantation
Heart Transplant
Right Ventricular Myocardial Changes in Specific Diseases
Cardiac Sarcoidosis
Dilated Cardiomyopathy
Hypertrophic Cardiomyopathy
References
Part IV: Treatment of Right Heart Dysfunction
16: Right-Heart Reverse Remodeling During Treatment for Pulmonary Hypertension
The Heart Remodeling
Right Ventricle Response to Chronic Pressure Overload
The Concept of Reverse Remodeling
Reverse Right Ventricular Remodeling in Patients with Pulmonary Hypertension: The Effect of Ventricular Unloading
The Evaluation of Right Ventricular Reverse Remodeling
The Impact of PAH-Specific Therapies on RV Reverse Remodeling
References
17: Acute Right-Heart Failure in Patients with Chronic Precapillary Pulmonary Hypertension
Introduction
Pathophysiology of Right-Heart Failure
Acute Right-Heart Failure Decompensation
Epidemiology of Acute Decompensated Pulmonary Hypertension and Prognosis
Treatment of RHF in ICU
Identification and Management of Triggering Factors
Fluid Status Optimization
Cardiac Output and Blood Pressure Optimization
RV Postload Optimization
Management of Refractory Right-Heart Failure
Urgent Lung and Heart-Lung Transplantation in Pulmonary Hypertension
Extracorporeal Life Support in Acute Decompensated Pulmonary Hypertension
Monitoring of Acute RHF in PH Patients
Clinical Monitoring
Circulating Biomarkers
Noninvasive Hemodynamic Evaluation
Invasive Hemodynamic Monitoring
Conclusion
References
18: Cardiac and Lung Transplantation and the Right Heart
Introduction
Donor Right Ventricular Failure in Cardiac Transplantation
Prediction of Risk of RV Failure in a Cardiac Transplant Candidate
Interpretation of Initial Hemodynamics
Pulmonary Artery Diastolic Pressure to Pulmonary Capillary Wedge Gradient
Acute Modulation of Hemodynamics
Acute Vasoreactivity Testing
Subacute Efforts to Improve Pulmonary Hemodynamics
Left Ventricular Assist Devices to Improve Pulmonary Hemodynamics
Lung and Heart-Lung Transplantation in Pulmonary Hypertension
Cardiac and Noncardiac Pathophysiology of the Advanced PAH Patient
Timing of Lung Transplantation in PAH1
Factors Relevant to a Previously Compensated Patient Who Suffers Abrupt Deterioration
Conclusions
References
19: Arrhythmias in Right-Heart Failure due to Pulmonary Hypertension
Introduction
Pathophysiology
Supraventricular Arrhythmias
Therapy
Ventricular Arrhythmias
Conclusion
References
20: Atrial Septostomy
Introduction
Rationale
Theoretical Background
Computational Models
Experimental Models
Clinical Evidence
Characteristics of Patients Submitted to Atrial Septostomy
Safety, Clinical and Hemodynamic Effects of Atrial Septostomy
Late Effects of Septostomy on Right Ventricular Function
Effects on Blood Gases and Oxygen Transport
Risks and Limitation of Atrial Septostomy
Atrial Septostomy and Therapeutic Strategy in Pulmonary Hypertension
Atrial Septostomy Plus Dedicated Devices for the Management of HF with Preserved Ejection Fraction
References
Part V: Future Perspectives
21: Treating the Right Ventricle Directly in Pulmonary Hypertension
Introduction
Drugs Targeting Pulmonary Hypertension That Are Vasodilators and May Have a Pressure-Independent Effect on the Right Ventricle
Myocardial Capillaries and Fibrosis in Right Ventricular Failure
Lessons Learned from Solving Hemodynamic Problems in Children with Congenital Cardiac Abnormalities
Reverse Potts Shunt
Lessons Learned: Age- and Disease-Related RV Function
Conclusions and Outlook
References
Index