Pulmonary circulatory – right ventricular uncoupling: New insights into pulmonary hypertension pathophysiology

David Boulate, Olaf Mercier, Julien Guihaire, Elie Fadel, Robert Naeije, Francois Haddad, Franz Rischard

Research output: Chapter in Book/Report/Conference proceedingChapter

7 Scopus citations


The pulmonary circulatory – right ventricular uncoupling is a key pathophysiological feature of pulmonary hypertension. Uncoupling develops when the ventricular contractility is not matched to its afterload due to a discordant response of the RV to increased afterload, or to an impaired right ventricular function. In this chapter we reported the methods which were developed to quantify the right ventricular –pulmonary artery (RV-PA) coupling in patients with PH and in experimental models of PH. The RV pressure-volume loop analysis are the gold standard to quantify RV-PA coupling metrics but more simple and less invasive methods were developed. We also reported how the RV-PA coupling metrics may be used to improve the phenotyping of patients and experimental models with PH. RV-PA coupling was also used to quantify the pharmacological effects of treatments in animal models with PH and to improve the understanding of the pathophysiological differences in different PH types. In recent studies, RV-PA coupling quantification with imaging methods showed interesting application to prognosis stratification of patients with PH.

Original languageEnglish (US)
Title of host publicationPulmonary Hypertension
Subtitle of host publicationBasic Science to Clinical Medicine
PublisherSpringer International Publishing
Number of pages13
ISBN (Electronic)9783319235943
ISBN (Print)9783319235936
StatePublished - Jan 1 2015
Externally publishedYes


  • Afterload
  • Coupling, ventricular adaptation
  • Elastance
  • Physiology
  • Pressure-volume loops
  • Pulmonary artery
  • Pulmonary circulation
  • Pulmonary hypertension
  • Right ventricle

ASJC Scopus subject areas

  • General Medicine


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