uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Right ventricular failure in idiopathic pulmonary arterial hypertension is associated with inefficient myocardial oxygen utilization
Department of Nuclear Medicine and PET Research, VU University Medical Center, Amsterdam, The Netherlands.
Show others and affiliations
2011 (English)In: Circulation Heart Failure, ISSN 1941-3289, Vol. 4, no 6, 700-706 p.Article in journal (Refereed) Published
Abstract [en]


In idiopathic pulmonary arterial hypertension (IPAH), increased right ventricular (RV) power is required to maintain cardiac output. For this, RV O2 consumption (MVO2) must increase by augmentation of O2 supply and/or improvement of mechanical efficiency–ratio of power output to MVO2. In IPAH with overt RV failure, however, there is evidence that O2 supply (perfusion) reserve is reduced, leaving only increase in either O2 extraction or mechanical efficiency as compensatory mechanisms. We related RV mechanical efficiency to clinical and hemodynamic parameters of RV function in patients with IPAH and associated it with glucose metabolism.

Methods and Results

The patients included were in New York Heart Association (NYHA) class II (n=8) and class III (n=8). They underwent right heart catheterization, MRI, and H215O-, 15O2-, C15O-, and 18FDG-PET. RV power and O2 supply were similar in both groups (NYHA class II versus class III: 0.54±0.14 versus 0.47±0.12 J/s and 0.109±0.022 versus 0.128±0.026 mL O2/min per gram, respectively). RV O2 extraction was near-significantly lower in NYHA class II compared with NYHA class III (63±17% versus 75±16%, respectively, P=0.10). As a result, MVO2 was significantly lower (0.066±0.012 versus 0.092±0.010 mL O2/min per gram, respectively, P=0.006). RV efficiency was reduced in NYHA class III (13.9±3.8%) compared with NYHA class II (27.8±7.6%, P=0.001). Septal bowing, measured by MRI, correlated with RV efficiency (r=−0.59, P=0.020). No relation was found between RV efficiency and glucose uptake rate. RV mechanical efficiency and ejection fraction were closely related (r=0.81, P<0.001).


RV failure in IPAH was associated with reduced mechanical efficiency that was partially explained by RV mechanical dysfunction but not by a metabolic shift.

Place, publisher, year, edition, pages
2011. Vol. 4, no 6, 700-706 p.
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-189072DOI: 10.1161/CIRCHEARTFAILURE.111.962381PubMedID: 21900188OAI: oai:DiVA.org:uu-189072DiVA: diva2:580608
Available from: 2012-12-23 Created: 2012-12-23 Last updated: 2013-03-01Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Lubberink, Mark
In the same journal
Circulation Heart Failure
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 144 hits
ReferencesLink to record
Permanent link

Direct link