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Targeting RV failure and cardiomyocyte injury in acute pulmonary thromboembolism

Nature Reviews Cardiology volume 10, page 559 (2013)Cite this article

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Marc Simon has reviewed the fundamental concepts underlying the diagnosis and therapy of a variety of clinical conditions associated with right ventricular (RV) failure (Simon, M. A. Assessment and treatment of right ventricular failure. Nat. Rev. Cardiol. 10, 204–218 [2013]).1 Although this Review is very clear and comprehensive, I would like to add a new perspective to the understanding of RV failure, and the therapeutic approach to this syndrome in the particular scenario of acute pulmonary thromboembolism (APT).

Multifocal necroinflammatory alterations (which reflect cell injury) are found in the right ventricle of patients with massive APT, and have major implications for both management and long-term prognosis.2 These RV alterations can be the result of matrix metalloproteinase (MMP) activation and release from infiltrating leucocytes or macrophages, and increase with the severity of the disease. Such changes to the right ventricle are associated with proportional increases in cardiac troponin I, a major biomarker of cardiomyocyte injury.3

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  1. Department of Pharmacology, Ribeirao Preto School of Medicine, University of Sao Paulo, Avenida dos Bandeirantes, 3900, Ribeirao Preto, Sao Paulo, 14049-900, Brazil

    Jose E. Tanus-Santos

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Tanus-Santos, J. Targeting RV failure and cardiomyocyte injury in acute pulmonary thromboembolism. Nat Rev Cardiol 10, 559 (2013). https://doi.org/10.1038/nrcardio.2013.12-c1

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