The role of the right ventricle in pulmonary arterial hypertension

Although changes in the pulmonary vasculature are the primary cause of pulmonary arterial hypertension (PAH), severity of symptoms and survival are strongly associated with right ventricular function, and right heart failure is the main cause of death in patients with PAH. Echocardiography and cardiac magnetic resonance imaging allow noninvasive evaluation of right ventricular function and structure, and a number of indices have been shown to have potential prognostic value in PAH. Given the importance of the right ventricle in PAH, preservation and improvement of its function should be important aspects of therapy; however, there are currently few data specifically related to this aspect of treatment response. Simple, reproducible, noninvasive measures of right ventricular function would help to improve the management of patients with PAH, and to provide tools with which to help establish the optimal therapeutic approach to manage not only the effects of the disease on the pulmonary vasculature, but also to support and improve right ventricular function

The oldest peracarid crustacean reveals a Late Devonian freshwater colonization by isopod relatives.

Peracarida (e.g. woodlice and side-swimmers) are, together with their sister-group Eucarida (e.g. krill and decapods), the most speciose group of modern crustaceans, suggested to have appeared as early as the Ordovician. While eucarids' incursion onto land consists of mainly freshwater and littoral grounds, some peracarids have evolved fully terrestrial ground-crawling ecologies, inhabiting even our gardens in temperate regions (e.g. pillbugs and sowbugs). Their fossil record extends back to the Carboniferous and consists mainly of marine occurrences. Here, we provide a complete re-analysis of a fossil arthropod-Oxyuropoda-reported in 1908 from the Late Devonian floodplains of Ireland, and left with unresolved systematic affinities despite a century of attempts at identification. Known from a single specimen preserved in two dimensions, we analysed its anatomy using digital microscopy and multispectral macroimaging to enhance the contrast of morphological structures. The new anatomical characters and completeness of Oxyuropoda, together with a phylogenetic analysis with representatives of all major Eumalacostraca groups, indicate that Oxyuropoda is a crown peracarid, part of a clade including amphipods and isopods. As such, Oxyuropoda is the oldest known species Peracarida, and provides evidence that derived peracarids had an incursion into freshwater and terrestrial environments as early as the Famennian, more than 360 Ma

Perspectives on novel therapeutic strategies for right heart failure in pulmonary arterial hypertension: lessons from the left heart

Right heart function is the main determinant of prognosis in pulmonary arterial hypertension (PAH). At present, no treatments are currently available that directly target the right ventricle, as we will demonstrate in this article. Meta-analysis of clinical trials in PAH revealed that current PAH medication seems to have limited cardiac-specific effects when analysed by the pump-function graph. Driven by the hypothesis that "left" and right heart failure might share important underlying pathophysiological mechanisms, we evaluated the clinical potential of left heart failure (LHF) therapies for PAH, based on currently available literature. As in LHF, the sympathetic nervous system and the renin–angiotension–aldosterone system are highly activated in PAH. From LHF we know that intervening in this process, e.g. by angiotensin-converting enzyme inhibition or β-blockade, is beneficial in the long run. Therefore, these medications could be also beneficial in PAH. Furthermore, the incidence of sudden cardiac death in PAH could be reduced by implantable cardioverter-defibrillators. Finally, pilot studies have demonstrated that interventricular dyssynchrony, present at end-stage PAH, responded favourably to cardiac resynchronisation therapy as well. In conclusion, therapies for LHF might be relevant for PAH. However, before they can be implemented in PAH management, safety and efficacy should be evaluated first in well-designed clinical trials

Effect of restrained versus free drying on hygro-expansion of hardwood and softwood fibers and paper handsheet

Earlier works in literature on the hygro-expansion of paper state that the larger hygro-expansivity of freely compared to restrained dried handsheets is due to structural differences between the fibers inside the handsheet. To unravel this hypothesis, first, the hygro-expansion of freely and restrained dried, hardwood and softwood handsheets has been characterized. Subsequently, the transient full-field hygro-expansion (longitudinal, transverse, and shear strain) of fibers extracted from these handsheets was measured using global digital height correlation, from which the micro-fibril angle was deduced. The hygro-expansivity of each individual fiber was tested before and after a wetting period, during which the fiber's moisture content is maximized, to analyze if a restrained dried fiber can "transform" into a freely dried fiber. It was found that the longitudinal hygro-expansion of the freely dried fibers is significantly larger than the restrained dried fibers, consistent with the sheet-scale differences. The difference in micro-fibril angle between the freely and restrained dried fibers is a possible explanation for this difference, but merely for the hardwood fibers, which are able to "transform" to freely dried fibers after being soaked in water. In contrast, this "transformation" does not happen in softwood fibers, even after full immersion in water for a day. Various mechanisms have been studied to explain the observations on freely and restrained dried hardwood and softwood, fiber and handsheets including analysis of the fibers' lumen and cross-sectional shape. The presented results and discussion deepens the understanding of the differences between freely and restrained dried handsheets.Comment: 43 pages, 15 figures, 2 table

Transient hygro- and hydro-expansion of freely and restrained dried paper: the fiber-network coupling

The transient dimensional changes during \textit{hygro}-expansion and \textit{hydro}-expansion of freely and restrained dried, softwood and hardwood sheets and fibers is monitored, to unravel the governing micro-mechanisms occurring during gradual water saturation. The response of individual fibers is measured using a full-field global digital height correlation method, which has been extended to monitor the transient \textit{hydro}-expansion of fibers from dry to fully saturated. The \textit{hygro}- and \textit{hydro}-expansion is larger for freely versus restrained dried and softwood versus hardwood handsheets. The transient sheet-scale \textit{hydro}-expansion reveals a sudden strain and moisture content step. It is postulated that the driving mechanism is the moisture-induced softening of the so-called "dislocated regions" in the fiber's cellulose micro-fibrils, unlocking further fiber swelling. The strain step is negligible for restrained dried handsheets, which is attributed to the "dislocated cellulose regions" being locked in their stretched configuration during restrained drying, which is supported by the single fiber \textit{hydro}-expansion measurements. Finally, an inter-fiber bond model is exploited and adapted to predict the sheet-scale \textit{hygro}-expansion from the fiber level characteristics. The model correctly predicts the qualitative differences between freely versus restrained dried and softwood versus hardwood handsheets, yet, its simplified geometry does not allow for more quantitative predictions of the sheet-scale \textit{hydro}-expansion.Comment: 37 pages; 12 figures; 5 table