PAH and rTOF exhibited distinct right ventricular remodeling, with PAH showing worse exercise tolerance and elevated dimethylglycine associated with worse RV function compared to rTOF and controls.
Observational
How do right ventricular remodeling, exercise capacity, and circulating metabolites differ between pressure-overloaded (PAH) and volume-overloaded (rTOF) states?
Pressure-overloaded (PAH) and volume-overloaded (rTOF) states exhibit distinct right ventricular remodeling and metabolic profiles, with PAH associated with worse exercise tolerance and specific metabolite alterations linked to RV dysfunction.
BACKGROUND: Ventricular pressure and volume overload may induce alterations in myocardial function, exercise capacity, and tissue metabolic pathways. OBJECTIVES: The authors investigated and compared these changes in pulmonary arterial hypertension (PAH) vs repaired tetralogy of Fallot (rTOF) with residual pulmonary regurgitation, which exemplify pressure- and volume-overloaded states, respectively. METHODS: ) on CPET. RESULTS: were associated negatively and positively in rTOF and control subjects, respectively. In PAH, dimethylglycine-which was elevated vs rTOF and control subjects-was associated positively with RVEDV/LVEDV and RV/LV mass, and negatively with RVEF, TAPSE, and RVGLS. CONCLUSIONS: PAH and rTOF exhibited distinct RV remodeling, and PAH, worse exercise tolerance. Differences in circulating branched chain amino acids and one-carbon metabolites were observed among rTOF, PAH, and control subjects.
Zhao et al. (Wed,) conducted a observational in Pulmonary arterial hypertension (PAH) and repaired tetralogy of Fallot (rTOF). Pulmonary arterial hypertension (PAH) and repaired tetralogy of Fallot (rTOF) vs. Control subjects was evaluated on RV remodeling, exercise tolerance, and circulating metabolites. PAH and rTOF exhibited distinct right ventricular remodeling, with PAH showing worse exercise tolerance and elevated dimethylglycine associated with worse RV function compared to rTOF and controls.