Abstract:
Cardiorenal syndrome (CRS) due to right ventricular (RV) failure is a disease entity emerging as a key indicator of morbidity and mortality. The multifactorial aspects of CRS and the left-right ventricular interdependence complicate the link between RV failure and renal function. RV failure has a direct pathophysiological link to renal dysfunction by leading to systemic venous congestion in certain circumstances and low cardiac output in other situations, both leading to impaired renal perfusion. Indeed, renal dysfunction is known to be an independent predictor of mortality in patients with pulmonary arterial hypertension (PAH) and RV failure. Thus, it is important to further understand the interaction between the RV and renal function. RV adaptation is critical to long-term survival in patients with PAH. The RV is also known for its remarkable capacity to recover once the aggravating factor is addressed or mitigated. However, less is known about the renal potential for recovery following the resolution of chronic RV failure. In this review, we provide an overview of the intricate relationship between RV dysfunction and the subsequent development of CRS, with a particular emphasis on PAH. Additionally, we summarize potential RV-targeted therapies and their potential beneficial impact on renal function.
摘要:
由于右心室(RV)衰竭引起的心肾综合征(CRS)是一种疾病实体,是发病率和死亡率的关键指标。CRS的多因素方面和左右心室的相互依赖性使RV衰竭和肾功能之间的联系复杂化。RV衰竭与肾功能障碍有直接的病理生理联系,在某些情况下导致全身静脉充血,在其他情况下导致低心输出量。均导致肾脏灌注受损。的确,已知肾功能不全是肺动脉高压(PAH)和RV衰竭患者死亡率的独立预测因子.因此,进一步了解右心室和肾功能之间的相互作用是非常重要的。RV适应对PAH患者的长期生存至关重要。一旦加重因素得到解决或减轻,RV也以其非凡的恢复能力而闻名。然而,关于慢性RV衰竭消退后肾脏恢复的潜力知之甚少。在这次审查中,我们概述了RV功能障碍与CRS后续发展之间的复杂关系,特别强调PAH。此外,我们总结了潜在的RV靶向治疗及其对肾功能的潜在有益影响.