Right ventricular (RV) dysfunction is important determinant of prognosis in patients at increased risk for development of RV overload. RV dysfunction in patients before and after surgical left... Show moreRight ventricular (RV) dysfunction is important determinant of prognosis in patients at increased risk for development of RV overload. RV dysfunction in patients before and after surgical left ventricular restoration is associated with a worse prognosis. RV overload in liver transplantation recipients was also associated with decreased survival. Furthermore, patients with congenital heart disease and an systemic RV are at increased risk for long-term complications caused by RV overload. No unique golden standard for the quantification of RV dysfunction exists. The combination of echocardiographic RV parameters yields additional prognostic information in heart failure patients undergoing surgical left ventricular restoration. In systemic sclerosis the electrical ventricular gradient can accurately detect RV overload and is consistent with other screening parameters in patients with limited organ involvement. Optimization of loading conditions can improve clinical status and RV function in patients with RV dysfunction. RV function can be improved in LVAD patients by optimizing the synergy between the LVAD and intrinsic cardiac function. Furthermore, interventions in complex congenital heart disease patients with pulmonary hypertension can improve RV loading conditions and true pulmonary flow and can improve RV loading conditions and clinical functioning. Show less
In neonatal rat ventricular cardiomyocytes (NRVCs), we activated integrins by RGD to test whether integrin stimulation produced hypertrophy. Effect of RGD was compared with pro-hypertrophic effects... Show moreIn neonatal rat ventricular cardiomyocytes (NRVCs), we activated integrins by RGD to test whether integrin stimulation produced hypertrophy. Effect of RGD was compared with pro-hypertrophic effects of phenylephrine (chapter 2). Ventricular failure is associated with disturbed collagen turnover. Myocardial collagen turnover can be assessed by plasma PINP, PIIINP, and ICTP representing collagen synthesis (PINP, PIIINP) or degradation (ICTP). We investigated the effects of cardiac resynchronization therapy (CRT) on collagen turnover in patients at baseline and after 6 months of CRT (chapter 3). Monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) and RV failure are associated with MMP activation in RV, we investigated whether NO plays role in RV hypertrophy and failure (chapter 4). In chapter 5 we reviewed novel approaches to treat experimental PAH. We investigated whether MCT-induced PAH and RV failure can be treated with mesenchymal stem cells (MSCs) from donor rats with PAH caused by MCT. At day 14 after MCT, recipient rats were treated with MSCs. In chapters 6,7 the effects of MSCs on pulmonary pathology and RV function were examined. Isolated cardiomyocytes were investigated for PAH-related changes in excitability. In chapter 8 we reported on excitability properties dependent on Kv-channel expression, proposed to play a role in arrhythmias. Show less
