The Biomechanics of Pulmonary Hypertension Secondary to Left Heart Failure

Pulmonary hypertension (PH) due to left heart failure (PH-LHF) is the most common cause of PH. This disease begins as pulmonary venous hypertension and then progresses to combined arterial and venous hypertension, which increases morbidity and mortality. The biomechanical and mechanobiological mechanisms that drive the transition from the first to the second, identified hemodynamically by increased pulmonary vascular resistance, are not well understood. We take an integrated experimental-modeling approach to advance knowledge in this area. We take a similar approach to understanding the impact of impaired left heart function on right heart function. Robust assessment of right heart mechanical function requires invasive catheterization with pressure-volume loop analysis at varying preloads. Discovering the mechanical mechanisms of pulmonary vascular and right ventricular dysfunction in PH-LHF is critical to understanding disease progression and developing novel therapies to prevent right ventricular and pulmonary vascular deterioration in response to LHF progression.