Collagen fiber remodeling and loss of tissue anisotropy provide a mechanistic understanding of the transition from adaptive to maladaptive right ventricular remodeling in pulmonary hypertension.
Multiscale biomechanical analysis indicated that, although hypertrophy and fibrosis occur in both mild and severe PH, certain fiber-level remodeling events, including increased tautness of collagen fibers and significant reorientations of myofibers, contributed to excessive biomechanical maladaptation of the RVFW leading to severe RV-pulmonary artery uncoupling. Collagen fiber remodeling and the loss of tissue anisotropy can provide an improved understanding of the transition from adaptive to maladaptive RV remodeling.
Neelakantan et al. (Wed,) studied this question.