Aging and Right Ventricular Failure from Pulmonary Hypertension: Effect of Right Ventricular and Pulmonary Artery Remodeling

Abstract

Prevalence of pulmonary hypertension (PHTN) is high in the community, affecting 10–20 % of the population and is even higher in elderly patients with left heart failure and chronic lung disease and obese patients with metabolic syndrome. Evidence indicates that aging alters the pulmonary vascular tree histology, right ventricular structure, and hemodynamics in the pulmonary circulation. There is not much research exploring mechanisms of how aging leads to right ventricular and pulmonary vascular remodeling. Although primary PHTN is rare, it is a better studied subset of PHTN and the mechanisms of that disease are better understood. Right ventricular remodeling and right heart failure (RHF) are crucial in determining clinical outcomes in primary PHTN, and similar findings are emerging in other types of PHTN, especially PHTN associated with left heart failure. Much more studies are needed to elucidate the clinical significance of right ventricular remodeling and failure in relation to aging and to define whether this could be a therapeutic target for improving outcomes of the disease.