Targeting the right ventricle in pulmonary Hypertension: in vivo and in vitro studies utilising selexipag

Cardiac MRI (CMR) provides accurate information regarding right ventricular mass, volume and markers of right ventricular function as well as right and left ventricular interaction in patients with pulmonary hypertension. Low stroke volume has been shown to be linked to mortality in pulmonary arterial hypertension (PAH) and CMR measurements of right ventricular ejection fraction (RVEF), left and right ventricular end diastolic volume (LVEDV and RVEDV) are also independent predictors of prognosis in subjects with PAH. At present, current treatment therapies target vasoconstriction and remodelling in the lungs, but there is little evidence of their effects in the heart, which is ultimately what patients with pulmonary hypertension succumb to. An improvement in right ventricular (RV) function may prolong the lives of these patients and therefore specifically targeting the heart as a possible treatment strategy is attractive and currently completely overlooked.