Key result
Right ventricular cardioprotective responses diverge from the left ventricle and may fail in RV failure.
Why the study?
While molecular mechanisms of conditioning in the left ventricle are well characterized, cardioprotection of the right ventricle is feasible but less established.
This review highlights that while the left and right ventricles share similar molecular mechanisms for ischaemic and pharmacological preconditioning, their responses to exercise-induced preconditioning differ.
RV preconditioning may fail in severe failure; leaves open ventricle-specific trials before clinical translation.
Ischaemic and pharmacological conditioning of the left ventricle is mediated by the activation of signalling cascades, which finally converge at the mitochondria and reduce ischaemia/reperfusion (I/R) injury. Whereas the molecular mechanisms of conditioning in the left ventricle are well characterized, cardioprotection of the right ventricle is principally feasible but less established. Similar to what is known for the left ventricle, a dysregulation in signalling pathways seems to play a role in I/R injury of the healthy and failing right ventricle and in the ability/inability of the right ventricle to respond to a conditioning stimulus. The maintenance of mitochondrial function seems to be crucial in both ventricles to reduce I/R injury. As far as currently known, similar molecular mechanisms mediate ischaemic and pharmacological preconditioning in the left and right ventricles. However, the two ventricles seem to respond differently towards exercise-induced preconditioning. LINKED ARTICLES: This article is part of a themed issue on Risk factors, comorbidities, and comedications in cardioprotection. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.23/issuetoc.
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Boengler et al. (2020) conducted a review in Ischaemia/reperfusion injury and right heart failure. Cardioprotective strategies (ischaemic, pharmacological, and exercise-induced conditioning) was evaluated. Although molecular mechanisms of preconditioning are similar in both ventricles, the right ventricle responds differently to exercise, and cardioprotection may be lost in right ventricular failure.
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