Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary Hypertension
Combined pre−/postcapillary pulmonary hypertension (Cpc‐PH), a complication of left heart failure, is associated with higher mortality rates than isolated postcapillary pulmonary hypertension alone. Currently, knowledge gaps persist on the mechanisms responsible for the progression of isolated postc...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.028121 |
| _version_ | 1797672597264007168 |
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| author | Betty J. Allen Hailey Frye Rasika Ramanathan Laura R. Caggiano Diana M. Tabima Naomi C. Chesler Jennifer L. Philip |
| author_facet | Betty J. Allen Hailey Frye Rasika Ramanathan Laura R. Caggiano Diana M. Tabima Naomi C. Chesler Jennifer L. Philip |
| author_sort | Betty J. Allen |
| collection | DOAJ |
| description | Combined pre−/postcapillary pulmonary hypertension (Cpc‐PH), a complication of left heart failure, is associated with higher mortality rates than isolated postcapillary pulmonary hypertension alone. Currently, knowledge gaps persist on the mechanisms responsible for the progression of isolated postcapillary pulmonary hypertension (Ipc‐PH) to Cpc‐PH. Here, we review the biomechanical and mechanobiological impact of left heart failure on pulmonary circulation, including mechanotransduction of these pathological forces, which lead to altered biological signaling and detrimental remodeling, driving the progression to Cpc‐PH. We focus on pathologically increased cyclic stretch and decreased wall shear stress; mechanotransduction by endothelial cells, smooth muscle cells, and pulmonary arterial fibroblasts; and signaling‐stimulated remodeling of the pulmonary veins, capillaries, and arteries that propel the transition from Ipc‐PH to Cpc‐PH. Identifying biomechanical and mechanobiological mechanisms of Cpc‐PH progression may highlight potential pharmacologic avenues to prevent right heart failure and subsequent mortality. |
| first_indexed | 2024-03-11T21:33:29Z |
| format | Article |
| id | doaj.art-0742ab69d287422b8c98263304fa3894 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-11T21:33:29Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-0742ab69d287422b8c98263304fa38942023-09-27T06:42:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-02-0112310.1161/JAHA.122.028121Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary HypertensionBetty J. Allen0Hailey Frye1Rasika Ramanathan2Laura R. Caggiano3Diana M. Tabima4Naomi C. Chesler5Jennifer L. Philip6Department of Surgery University of Wisconsin‐Madison Madison WIDepartment of Biomedical Engineering University of Wisconsin‐Madison Madison WIDepartment of Biomedical Engineering University of Wisconsin‐Madison Madison WIEdwards Lifesciences Foundation Cardiovascular Innovation and Research Center and Department of Biomedical Engineering University of California Irvine CADepartment of Biomedical Engineering University of Wisconsin‐Madison Madison WIDepartment of Biomedical Engineering University of Wisconsin‐Madison Madison WIDepartment of Surgery University of Wisconsin‐Madison Madison WICombined pre−/postcapillary pulmonary hypertension (Cpc‐PH), a complication of left heart failure, is associated with higher mortality rates than isolated postcapillary pulmonary hypertension alone. Currently, knowledge gaps persist on the mechanisms responsible for the progression of isolated postcapillary pulmonary hypertension (Ipc‐PH) to Cpc‐PH. Here, we review the biomechanical and mechanobiological impact of left heart failure on pulmonary circulation, including mechanotransduction of these pathological forces, which lead to altered biological signaling and detrimental remodeling, driving the progression to Cpc‐PH. We focus on pathologically increased cyclic stretch and decreased wall shear stress; mechanotransduction by endothelial cells, smooth muscle cells, and pulmonary arterial fibroblasts; and signaling‐stimulated remodeling of the pulmonary veins, capillaries, and arteries that propel the transition from Ipc‐PH to Cpc‐PH. Identifying biomechanical and mechanobiological mechanisms of Cpc‐PH progression may highlight potential pharmacologic avenues to prevent right heart failure and subsequent mortality.https://www.ahajournals.org/doi/10.1161/JAHA.122.028121biomechanicsmechanotransductionpulmonary hypertension due to left heart failurepulmonary vascular remodeling |
| spellingShingle | Betty J. Allen Hailey Frye Rasika Ramanathan Laura R. Caggiano Diana M. Tabima Naomi C. Chesler Jennifer L. Philip Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary Hypertension Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease biomechanics mechanotransduction pulmonary hypertension due to left heart failure pulmonary vascular remodeling |
| title | Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary Hypertension |
| title_full | Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary Hypertension |
| title_fullStr | Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary Hypertension |
| title_full_unstemmed | Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary Hypertension |
| title_short | Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre−/PostCapillary Pulmonary Hypertension |
| title_sort | biomechanical and mechanobiological drivers of the transition from postcapillary pulmonary hypertension to combined pre postcapillary pulmonary hypertension |
| topic | biomechanics mechanotransduction pulmonary hypertension due to left heart failure pulmonary vascular remodeling |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.028121 |
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