Assessment of right ventricular function in the research setting

Knowledge gaps and pathways forward an official American thoracic society research statement

Tim Lahm, Ivor S. Douglas, Stephen L. Archer, Harm J. Bogaard, Naomi C. Chesler, Francois Haddad, Anna R. Hemnes, Steven M. Kawut, Jeffrey A. Kline, Todd Matthew Kolb, Stephen Mathai, Olaf Mercier, Evangelos D. Michelakis, Robert Naeije, Rubin M. Tuder, Corey E. Ventetuolo, Antoine Vieillard-Baron, Norbert F. Voelkel, Anton Vonk-Noordegraaf, Paul M Hassoun

Research output: Contribution to journalReview article

Abstract

Background: Right ventricular (RV) adaptation to acute and chronic pulmonary hypertensive syndromes is a significant determinant of short- and long-term outcomes. Although remarkable progress has been made in the understanding of RV function and failure since the meeting of the NIH Working Group on Cellular and Molecular Mechanisms of Right Heart Failure in 2005, significant gaps remain at many levels in the understanding of cellular and molecular mechanisms of RV responses to pressure and volume overload, in the validation of diagnostic modalities, and in the development of evidence-based therapies. Methods: A multidisciplinary working group of 20 international experts from the American Thoracic Society Assemblies on Pulmonary Circulation and Critical Care, as well as external content experts, reviewed the literature, identified important knowledge gaps, and provided recommendations. Results: This document reviews the knowledge in the field of RV failure, identifies and prioritizes themost pertinent research gaps, and provides a prioritized pathway for addressing these preclinical and clinical questions. The group identified knowledge gaps and research opportunities in three major topic areas: 1) optimizing the methodology to assess RV function in acute and chronic conditions in preclinical models, human studies, and clinical trials; 2) analyzing advanced RV hemodynamic parameters at rest and in response to exercise; and 3) deciphering the underlying molecular and pathogenic mechanisms of RV function and failure in diverse pulmonary hypertension syndromes. Conclusions: This statement provides a roadmap to further advance the state of knowledge, with the ultimate goal of developing RV-targeted therapies for patients with RV failure of any etiology.

Original languageEnglish (US)
Pages (from-to)e15-e43
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume198
Issue number4
DOIs
StatePublished - Aug 15 2018

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Right Ventricular Function
Thorax
Research
Pulmonary Circulation
Patient Rights
Critical Care
Pulmonary Hypertension
Heart Failure
Hemodynamics
Clinical Trials
Pressure
Lung
Therapeutics

Keywords

  • Acute respiratory distress syndrome
  • Pulmonary circulation
  • Pulmonary embolism
  • Pulmonary hypertension
  • Right ventricle

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Assessment of right ventricular function in the research setting : Knowledge gaps and pathways forward an official American thoracic society research statement. / Lahm, Tim; Douglas, Ivor S.; Archer, Stephen L.; Bogaard, Harm J.; Chesler, Naomi C.; Haddad, Francois; Hemnes, Anna R.; Kawut, Steven M.; Kline, Jeffrey A.; Kolb, Todd Matthew; Mathai, Stephen; Mercier, Olaf; Michelakis, Evangelos D.; Naeije, Robert; Tuder, Rubin M.; Ventetuolo, Corey E.; Vieillard-Baron, Antoine; Voelkel, Norbert F.; Vonk-Noordegraaf, Anton; Hassoun, Paul M.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 198, No. 4, 15.08.2018, p. e15-e43.

Research output: Contribution to journalReview article

Lahm, T, Douglas, IS, Archer, SL, Bogaard, HJ, Chesler, NC, Haddad, F, Hemnes, AR, Kawut, SM, Kline, JA, Kolb, TM, Mathai, S, Mercier, O, Michelakis, ED, Naeije, R, Tuder, RM, Ventetuolo, CE, Vieillard-Baron, A, Voelkel, NF, Vonk-Noordegraaf, A & Hassoun, PM 2018, 'Assessment of right ventricular function in the research setting: Knowledge gaps and pathways forward an official American thoracic society research statement', American Journal of Respiratory and Critical Care Medicine, vol. 198, no. 4, pp. e15-e43. https://doi.org/10.1164/rccm.201806-1160ST
Lahm, Tim ; Douglas, Ivor S. ; Archer, Stephen L. ; Bogaard, Harm J. ; Chesler, Naomi C. ; Haddad, Francois ; Hemnes, Anna R. ; Kawut, Steven M. ; Kline, Jeffrey A. ; Kolb, Todd Matthew ; Mathai, Stephen ; Mercier, Olaf ; Michelakis, Evangelos D. ; Naeije, Robert ; Tuder, Rubin M. ; Ventetuolo, Corey E. ; Vieillard-Baron, Antoine ; Voelkel, Norbert F. ; Vonk-Noordegraaf, Anton ; Hassoun, Paul M. / Assessment of right ventricular function in the research setting : Knowledge gaps and pathways forward an official American thoracic society research statement. In: American Journal of Respiratory and Critical Care Medicine. 2018 ; Vol. 198, No. 4. pp. e15-e43.
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abstract = "Background: Right ventricular (RV) adaptation to acute and chronic pulmonary hypertensive syndromes is a significant determinant of short- and long-term outcomes. Although remarkable progress has been made in the understanding of RV function and failure since the meeting of the NIH Working Group on Cellular and Molecular Mechanisms of Right Heart Failure in 2005, significant gaps remain at many levels in the understanding of cellular and molecular mechanisms of RV responses to pressure and volume overload, in the validation of diagnostic modalities, and in the development of evidence-based therapies. Methods: A multidisciplinary working group of 20 international experts from the American Thoracic Society Assemblies on Pulmonary Circulation and Critical Care, as well as external content experts, reviewed the literature, identified important knowledge gaps, and provided recommendations. Results: This document reviews the knowledge in the field of RV failure, identifies and prioritizes themost pertinent research gaps, and provides a prioritized pathway for addressing these preclinical and clinical questions. The group identified knowledge gaps and research opportunities in three major topic areas: 1) optimizing the methodology to assess RV function in acute and chronic conditions in preclinical models, human studies, and clinical trials; 2) analyzing advanced RV hemodynamic parameters at rest and in response to exercise; and 3) deciphering the underlying molecular and pathogenic mechanisms of RV function and failure in diverse pulmonary hypertension syndromes. Conclusions: This statement provides a roadmap to further advance the state of knowledge, with the ultimate goal of developing RV-targeted therapies for patients with RV failure of any etiology.",
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T2 - Knowledge gaps and pathways forward an official American thoracic society research statement

AU - Lahm, Tim

AU - Douglas, Ivor S.

AU - Archer, Stephen L.

AU - Bogaard, Harm J.

AU - Chesler, Naomi C.

AU - Haddad, Francois

AU - Hemnes, Anna R.

AU - Kawut, Steven M.

AU - Kline, Jeffrey A.

AU - Kolb, Todd Matthew

AU - Mathai, Stephen

AU - Mercier, Olaf

AU - Michelakis, Evangelos D.

AU - Naeije, Robert

AU - Tuder, Rubin M.

AU - Ventetuolo, Corey E.

AU - Vieillard-Baron, Antoine

AU - Voelkel, Norbert F.

AU - Vonk-Noordegraaf, Anton

AU - Hassoun, Paul M

PY - 2018/8/15

Y1 - 2018/8/15

N2 - Background: Right ventricular (RV) adaptation to acute and chronic pulmonary hypertensive syndromes is a significant determinant of short- and long-term outcomes. Although remarkable progress has been made in the understanding of RV function and failure since the meeting of the NIH Working Group on Cellular and Molecular Mechanisms of Right Heart Failure in 2005, significant gaps remain at many levels in the understanding of cellular and molecular mechanisms of RV responses to pressure and volume overload, in the validation of diagnostic modalities, and in the development of evidence-based therapies. Methods: A multidisciplinary working group of 20 international experts from the American Thoracic Society Assemblies on Pulmonary Circulation and Critical Care, as well as external content experts, reviewed the literature, identified important knowledge gaps, and provided recommendations. Results: This document reviews the knowledge in the field of RV failure, identifies and prioritizes themost pertinent research gaps, and provides a prioritized pathway for addressing these preclinical and clinical questions. The group identified knowledge gaps and research opportunities in three major topic areas: 1) optimizing the methodology to assess RV function in acute and chronic conditions in preclinical models, human studies, and clinical trials; 2) analyzing advanced RV hemodynamic parameters at rest and in response to exercise; and 3) deciphering the underlying molecular and pathogenic mechanisms of RV function and failure in diverse pulmonary hypertension syndromes. Conclusions: This statement provides a roadmap to further advance the state of knowledge, with the ultimate goal of developing RV-targeted therapies for patients with RV failure of any etiology.

AB - Background: Right ventricular (RV) adaptation to acute and chronic pulmonary hypertensive syndromes is a significant determinant of short- and long-term outcomes. Although remarkable progress has been made in the understanding of RV function and failure since the meeting of the NIH Working Group on Cellular and Molecular Mechanisms of Right Heart Failure in 2005, significant gaps remain at many levels in the understanding of cellular and molecular mechanisms of RV responses to pressure and volume overload, in the validation of diagnostic modalities, and in the development of evidence-based therapies. Methods: A multidisciplinary working group of 20 international experts from the American Thoracic Society Assemblies on Pulmonary Circulation and Critical Care, as well as external content experts, reviewed the literature, identified important knowledge gaps, and provided recommendations. Results: This document reviews the knowledge in the field of RV failure, identifies and prioritizes themost pertinent research gaps, and provides a prioritized pathway for addressing these preclinical and clinical questions. The group identified knowledge gaps and research opportunities in three major topic areas: 1) optimizing the methodology to assess RV function in acute and chronic conditions in preclinical models, human studies, and clinical trials; 2) analyzing advanced RV hemodynamic parameters at rest and in response to exercise; and 3) deciphering the underlying molecular and pathogenic mechanisms of RV function and failure in diverse pulmonary hypertension syndromes. Conclusions: This statement provides a roadmap to further advance the state of knowledge, with the ultimate goal of developing RV-targeted therapies for patients with RV failure of any etiology.

KW - Acute respiratory distress syndrome

KW - Pulmonary circulation

KW - Pulmonary embolism

KW - Pulmonary hypertension

KW - Right ventricle

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