The importance of right ventricular remodelling in pulmonary arterial hypertension

Interestingly, these patients showed the highest cardiac index, mixed venous oxygen saturation, RV ejection fraction and RV-pulmonary arterial coupling, the lowest mean pulmonary artery pressure and pulmonary vascular resistance (PVR), and the smallest right atrium area. Despite all treatments improve haemodynamics (cardiac index increase and PVR reduction), only more aggressive strategies such as double oral upfront or triple upfront combination including parenteral prostanoids are able to achieve a critical PVR reduction, increasing the likelihood of reverse RV remodelling. [...]patients’ treatment response to similar strategies (ie, upfront double oral or upfront triple therapy including parenteral prostanoids) has been shown to be heterogeneous.3 5 6 10 Does it depend on the different compounds or timing?