open access

Vol 81, No 2 (2022)
Original article
Submitted: 2020-12-19
Accepted: 2021-03-11
Published online: 2021-04-13
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Arterial hypertension and remodelling of the right ventricle

A. Kosiński1, G. M. Piwko1, R. Kamiński1, E. Nowicka1, A. Kaczyńska1, M. Zajączkowski1, K. Czerwiec1, M. Gleinert-Rożek1, K. Karnecki2, T. Gos2
·
Pubmed: 33899208
·
Folia Morphol 2022;81(2):336-342.
Affiliations
  1. Department of Clinical Anatomy, Gdansk Medical University, Gdansk, Poland
  2. Department of Forensic Medicine, Gdansk Medical University, Gdansk, Poland

open access

Vol 81, No 2 (2022)
ORIGINAL ARTICLES
Submitted: 2020-12-19
Accepted: 2021-03-11
Published online: 2021-04-13

Abstract

Background: In the case of long-term and physiological loads (e.g. during pregnancy or regular athletics training), reversible morphological changes occur in the heart — cardiomyocytes undergo hypertrophy; however, this is not accompanied by impairment of left ventricular function or myocyte metabolism. However, in the course of various pathological processes, as time goes by, gradually permanent morphological changes occur. These changes are referred to as remodelling of the heart muscle, which, regardless of the primary cause, can lead to the development of chronic heart failure.
Materials and methods: The study was performed on post-mortem material of 35 human hearts obtained from forensic sections and anatomopathological sections of people who died of non-cardiac causes (mainly traffic accidents, suicide attempts, strokes, acute infections); material was fixed in a 4% formalin solution. The hearts were subjected to macro- and microscopic assessment. During microscopic assessment the features of remodelling were evaluated.
Results and Conclusions: In vivo and echocardiographic tests, as well as macroscopic evaluation of post-mortem material, suggest the presence of some kind of right ventricular muscle remodelling; however, classic microscopic observations, presented in this study, do not provide such unambiguous evidence. Thus, the question arises: why and how the right ventricular function is disturbed, sometimes at early stages of arterial hypertension.

Abstract

Background: In the case of long-term and physiological loads (e.g. during pregnancy or regular athletics training), reversible morphological changes occur in the heart — cardiomyocytes undergo hypertrophy; however, this is not accompanied by impairment of left ventricular function or myocyte metabolism. However, in the course of various pathological processes, as time goes by, gradually permanent morphological changes occur. These changes are referred to as remodelling of the heart muscle, which, regardless of the primary cause, can lead to the development of chronic heart failure.
Materials and methods: The study was performed on post-mortem material of 35 human hearts obtained from forensic sections and anatomopathological sections of people who died of non-cardiac causes (mainly traffic accidents, suicide attempts, strokes, acute infections); material was fixed in a 4% formalin solution. The hearts were subjected to macro- and microscopic assessment. During microscopic assessment the features of remodelling were evaluated.
Results and Conclusions: In vivo and echocardiographic tests, as well as macroscopic evaluation of post-mortem material, suggest the presence of some kind of right ventricular muscle remodelling; however, classic microscopic observations, presented in this study, do not provide such unambiguous evidence. Thus, the question arises: why and how the right ventricular function is disturbed, sometimes at early stages of arterial hypertension.

Get Citation

Keywords

heart, human, changes, hypertensive

About this article
Title

Arterial hypertension and remodelling of the right ventricle

Journal

Folia Morphologica

Issue

Vol 81, No 2 (2022)

Article type

Original article

Pages

336-342

Published online

2021-04-13

Page views

5401

Article views/downloads

963

DOI

10.5603/FM.a2021.0038

Pubmed

33899208

Bibliographic record

Folia Morphol 2022;81(2):336-342.

Keywords

heart
human
changes
hypertensive

Authors

A. Kosiński
G. M. Piwko
R. Kamiński
E. Nowicka
A. Kaczyńska
M. Zajączkowski
K. Czerwiec
M. Gleinert-Rożek
K. Karnecki
T. Gos

References (27)
  1. Anrep GV, Häusler H. The coronary circulation: I. The effect of changes of the blood-pressure and of the output of the heart. J Physiol. 1928; 65(4): 357–373.
  2. Biernacki W, Flenley DC, Muir AL, et al. Pulmonary hypertension and right ventricular function in patients with COPD. Chest. 1988; 94(6): 1169–1175.
  3. Cicala S, Galderisi M, Caso P, et al. Right ventricular diastolic dysfunction in arterial systemic hypertension: analysis by pulsed tissue Doppler. Eur J Echocardiogr. 2002; 3(2): 135–142.
  4. Cohn JN. Structural basis for heart failure. Ventricular remodeling and its pharmacological inhibition. Circulation. 1995; 91(10): 2504–2507.
  5. Cuspidi C, Sampieri L, Angioni L, et al. Right ventricular wall thickness and function in hypertensive patients with and without left ventricular hypertrophy: echo-Doppler study. J Hypertens Suppl. 1989; 7(6): S108–S109.
  6. Cuspidi C, Valerio C, Sala C, et al. Prevalence and correlates of left atrial enlargement in essential hypertension: role of ventricular geometry and the metabolic syndrome: the Evaluation of Target Organ Damage in Hypertension study. J Hypertens. 2005; 23(4): 875–882.
  7. D'Andrea A, Caso P, Scarafile R, et al. Biventricular myocardial adaptation to different training protocols in competitive master athletes. Int J Cardiol. 2007; 115(3): 342–349.
  8. Dong L, Mintz GS, Witzenbichler B, et al. Comparison of plaque characteristics in narrowings with ST-elevation myocardial infarction (STEMI), non-STEMI/unstable angina pectoris and stable coronary artery disease (from the ADAPT-DES IVUS Substudy). Am J Cardiol. 2015; 115(7): 860–866.
  9. Franco V. Right ventricular remodeling in pulmonary hypertension. Heart Fail Clin. 2012; 8(3): 403–412.
  10. Grajek S. Patofizjologia przebudowy serca. In: Szyszka A (ed.). Przebudowa serca. ViaMedica, Gdańsk 2002: 1–30.
  11. Harrison A, Hatton N, Ryan JJ. The right ventricle under pressure: evaluating the adaptive and maladaptive changes in the right ventricle in pulmonary arterial hypertension using echocardiography (2013 Grover Conference series). Pulm Circ. 2015; 5(1): 29–47.
  12. Kamiński L, Płońska E, Szyszka A, et al. [Echocardiographic examination of cardiac structure and function in male athletes of static and dynamic disciplines]. Pol Merkur Lek. 2006; 20(117): 274–278.
  13. Latus H, Gummel K, Klingel K, et al. Focal myocardial fibrosis assessed by late gadolinium enhancement cardiovascular magnetic resonance in children and adolescents with dilated cardiomyopathy. J Cardiovasc Magn Reson. 2015; 17: 34.
  14. Limbourg P, Wende W, Henrich H, et al. [Frequency potentiation and Frank-Starling mechanism in canine ventricle under sinus node rhythm and ventricular pacing]. Pflugers Arch. 1971; 322(3): 250–263.
  15. Park JiY, Ryu SK, Choi JW, et al. Association of inflammation, myocardial fibrosis and cardiac remodelling in patients with mild aortic stenosis as assessed by biomarkers and echocardiography. Clin Exp Pharmacol Physiol. 2014; 41(3): 185–191.
  16. Pedrinelli R, Canale ML, Giannini C, et al. Abnormal right ventricular mechanics in early systemic hypertension: a two-dimensional strain imaging study. Eur J Echocardiogr. 2010; 11(9): 738–742.
  17. Pedrinelli R, Canale ML, Giannini C, et al. Right ventricular dysfunction in early systemic hypertension: a tissue Doppler imaging study in patients with high-normal and mildly increased arterial blood pressure. J Hypertens. 2010; 28(3): 615–621.
  18. Puchades R, Ruiz-Nodar JM, Blanco F, et al. An analysis of cardiac remodeling in the elderly population. EPICARDIAN study. Rev Esp Cardiol. 2010; 63(8): 989–991.
  19. Rodrigues JCL, Amadu AM, Dastidar AG, et al. Prevalence and predictors of asymmetric hypertensive heart disease: insights from cardiac and aortic function with cardiovascular magnetic resonance. Eur Heart J Cardiovasc Imaging. 2016; 17(12): 1405–1413.
  20. Schannwell CM, Zimmermann T, Schneppenheim M, et al. Left ventricular hypertrophy and diastolic dysfunction in healthy pregnant women. Cardiology. 2002; 97(2): 73–78.
  21. Schuleri KH, Centola M, Evers KS, et al. Cardiovascular magnetic resonance characterization of peri-infarct zone remodeling following myocardial infarction. J Cardiovasc Magn Reson. 2012; 14: 24.
  22. Tadic M, Cuspidi C, Pencic B, et al. High-normal blood pressure impacts the right heart mechanics: a three-dimensional echocardiography and two-dimensional speckle tracking imaging study. Blood Press Monit. 2014; 19(3): 145–152.
  23. Tadic M, Cuspidi C, Pencic B, et al. Relationship between right ventricular remodeling and heart rate variability in arterial hypertension. J Hypertens. 2015; 33(5): 1090–1097.
  24. Tadic M, Ivanovic B, Celic V, et al. Are the metabolic syndrome, blood pressure pattern, and their interaction responsible for the right ventricular remodeling? Blood Press Monit. 2013; 18(4): 195–202.
  25. Tadic M, Ivanovic B, Celic V, et al. The impact of metabolic syndrome, recently diagnosed diabetes and hypertension on right ventricular remodeling. Is there difference between risk factors? Clin Exp Hypertens. 2014; 36(5): 295–301.
  26. Tumuklu MM, Erkorkmaz U, Ocal A. The impact of hypertension and hypertension-related left ventricle hypertrophy on right ventricle function. Echocardiography. 2007; 24(4): 374–384.
  27. Weber KT, Sun Y, Guarda E. Structural remodeling in hypertensive heart disease and the role of hormones. Hypertension. 1994; 23(6 Pt 2): 869–877.

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