Right Ventricular Remodeling and Function in Hypoplastic Left Heart Syndrome

The right ventricle (RV) in hypoplastic left heart syndrome (HLHS) becomes the systemic ventricle pumping against systemic afterload. It also has to adapt to an initially increased volume load followed by a decrease in volume load after Fontan completion. Anatomical HLHS subtype, therapeutic strateg...

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Main Authors: Thomas Salaets, MD, PhD, Marc Gewillig, MD, PhD, Alexander Van De Bruaene, MD, PhD, Luc L. Mertens, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JACC: Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772963X24006914
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author Thomas Salaets, MD, PhD
Marc Gewillig, MD, PhD
Alexander Van De Bruaene, MD, PhD
Luc L. Mertens, MD, PhD
author_facet Thomas Salaets, MD, PhD
Marc Gewillig, MD, PhD
Alexander Van De Bruaene, MD, PhD
Luc L. Mertens, MD, PhD
author_sort Thomas Salaets, MD, PhD
collection DOAJ
description The right ventricle (RV) in hypoplastic left heart syndrome (HLHS) becomes the systemic ventricle pumping against systemic afterload. It also has to adapt to an initially increased volume load followed by a decrease in volume load after Fontan completion. Anatomical HLHS subtype, therapeutic strategy, tricuspid valve regurgitation, recoarctation, and genetics influence RV size and function. The resulting remodeling process can be maladaptive and lead to ventricular systolic and diastolic dysfunction. While systolic dysfunction is a strong predictor for mortality before Fontan, there is increasing evidence for the impact of progressive diastolic dysfunction after Fontan. This comprehensive review summarizes the (recent) empirical observations that increased understanding of RV remodeling and function in HLHS. It aims at clinicians and researchers wishing to increase their understanding of the physiology of this disease. It highlights the potential for future scientific work on the assessment and preservation of myocardial health throughout the palliation.
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series JACC: Advances
spelling doaj-art-1d81972dcbac45d795dea874a9e97d652024-11-22T07:40:01ZengElsevierJACC: Advances2772-963X2024-12-01312101411Right Ventricular Remodeling and Function in Hypoplastic Left Heart SyndromeThomas Salaets, MD, PhD0Marc Gewillig, MD, PhD1Alexander Van De Bruaene, MD, PhD2Luc L. Mertens, MD, PhD3Division of Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium; The Labatt Family Heart Centre, Division of Cardiology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, CanadaDivision of Pediatric Cardiology, University Hospitals Leuven, Leuven, BelgiumDivision of Adult Congenital Heart Disease, University Hospitals Leuven, Leuven, BelgiumThe Labatt Family Heart Centre, Division of Cardiology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Canada; Address for correspondence: Dr Luc Mertens, Division of Cardiology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.The right ventricle (RV) in hypoplastic left heart syndrome (HLHS) becomes the systemic ventricle pumping against systemic afterload. It also has to adapt to an initially increased volume load followed by a decrease in volume load after Fontan completion. Anatomical HLHS subtype, therapeutic strategy, tricuspid valve regurgitation, recoarctation, and genetics influence RV size and function. The resulting remodeling process can be maladaptive and lead to ventricular systolic and diastolic dysfunction. While systolic dysfunction is a strong predictor for mortality before Fontan, there is increasing evidence for the impact of progressive diastolic dysfunction after Fontan. This comprehensive review summarizes the (recent) empirical observations that increased understanding of RV remodeling and function in HLHS. It aims at clinicians and researchers wishing to increase their understanding of the physiology of this disease. It highlights the potential for future scientific work on the assessment and preservation of myocardial health throughout the palliation.http://www.sciencedirect.com/science/article/pii/S2772963X24006914congenital cardiologyFontanhypoplastic left heart syndromesingle ventricle diseaseventricular remodeling
spellingShingle Thomas Salaets, MD, PhD
Marc Gewillig, MD, PhD
Alexander Van De Bruaene, MD, PhD
Luc L. Mertens, MD, PhD
Right Ventricular Remodeling and Function in Hypoplastic Left Heart Syndrome
JACC: Advances
congenital cardiology
Fontan
hypoplastic left heart syndrome
single ventricle disease
ventricular remodeling
title Right Ventricular Remodeling and Function in Hypoplastic Left Heart Syndrome
title_full Right Ventricular Remodeling and Function in Hypoplastic Left Heart Syndrome
title_fullStr Right Ventricular Remodeling and Function in Hypoplastic Left Heart Syndrome
title_full_unstemmed Right Ventricular Remodeling and Function in Hypoplastic Left Heart Syndrome
title_short Right Ventricular Remodeling and Function in Hypoplastic Left Heart Syndrome
title_sort right ventricular remodeling and function in hypoplastic left heart syndrome
topic congenital cardiology
Fontan
hypoplastic left heart syndrome
single ventricle disease
ventricular remodeling
url http://www.sciencedirect.com/science/article/pii/S2772963X24006914
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