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Pulmonary Hypertension, Right Ventricular Failure, and Kidney: Different from Left Ventricular Failure?

University of Colorado Health Sciences Center, Denver, Colorado

Correspondence: Dr. Robert W. Schrier, University of Colorado School of Medicine, 4200 East Ninth Avenue B173, Biomedical Research Building Room 723, Denver, CO 80262. Phone: 303-315-8059; Fax: 303-315-2685; E-mail: robert.schrier{at}uchsc.edu

In this article, the pathophysiology of left ventricular failure is reviewed. By contrast, the paucity of information about pulmonary arterial hypertension and right ventricular failure is acknowledged. The potential mechanisms whereby renal sodium and water retention in right ventricular failure secondary to pulmonary arterial hypertension can occur, despite normal left ventricular function, are discussed. With right ventricular failure as the primary cause of death in patients with pulmonary hypertension, more information about the mechanisms of renal sodium and water retention in these patients is direly needed. Specifically, studies to examine the activation of the neurohumoral axis at various stages of pulmonary arterial hypertension and right ventricular failure, including inhibition of mineralocorticoid and V2 vasopressin receptors, are indicated.

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