Physiological mechanisms of pulmonary hypertension

Abstract Pulmonary hypertension is usually related to obstruction of pulmonary blood flow at the level of the pulmonary arteries (e.g. pulmonary embolus), pulmonary arterioles (idiopathic pulmonary hypertension), pulmonary veins (pulmonary veno-occlusive disease) or mitral valve (mitral stenosis and...

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Bibliographic Details
Published in:The American heart journal 2016-10, Vol.180, p.1-11
Main Authors: MacIver, David H, Adeniran, Ismail, MacIver, Iain R, Revell, Alistair, Zhang, Henggui
Format: Article
Language:English
Subjects:
Cardiomyopathy
Cardiovascular
Disease
Edema
Flow velocity
Fluid mechanics
Heart failure
Humans
Hydrodynamics
Hypertension, Pulmonary - physiopathology
Navier-Stokes equations
Physiology
Pulmonary arteries
Pulmonary Circulation - physiology
Pulmonary hypertension
Thermodynamics
Veins & arteries
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Summary:Abstract Pulmonary hypertension is usually related to obstruction of pulmonary blood flow at the level of the pulmonary arteries (e.g. pulmonary embolus), pulmonary arterioles (idiopathic pulmonary hypertension), pulmonary veins (pulmonary veno-occlusive disease) or mitral valve (mitral stenosis and regurgitation). Pulmonary hypertension is also observed in heart failure due to left ventricle myocardial diseases regardless of the ejection fraction. Pulmonary hypertension is often regarded as a passive response to the obstruction to pulmonary flow. We review established fluid dynamics and physiology and discuss the mechanisms underlying pulmonary hypertension. The important role that the right ventricle plays in the development and maintenance of pulmonary hypertension is discussed. We use principles of thermodynamics and discuss a potential common mechanism for a number of disease states, including pulmonary edema, through adding pressure energy to the pulmonary circulation.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2016.07.003