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2026
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| Online Access: | https://doi.org/10.5281/zenodo.20218781 |
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| _version_ | 1866902213091131392 |
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| author | Indunil Karunarathna |
| author_facet | Indunil Karunarathna |
| contents | <p class="MsoNormal"><span>Pulmonary vascular resistance (PVR) represents a critical hemodynamic parameter governing right ventricular afterload, ventilation-perfusion matching, and gas exchange efficiency within the pulmonary circulation. Unlike the systemic circulation, where high resistance sustains arterial pressure, the pulmonary circuit operates as a low-resistance, high-capacitance system optimized to accommodate the entire cardiac output at mean pressures approximately one-tenth those of the systemic circulation. This review examines the physiological modeling of PVR through Ohm's and Poiseuille's laws, acknowledging their inherent limitations when applied to a pulsatile, non-Newtonian, and mechanically dynamic vascular bed. The mechanisms regulating PVR—including pulmonary intravascular pressure, lung volume, gravitational gradients, alveolar hypoxia, and smooth muscle tonicity—are explored in depth, emphasizing the integrated mechanical, biochemical, and neural control systems that maintain low resting resistance while preserving adaptive reserve. Pathophysiologically, sustained elevation of PVR drives pulmonary hypertension, triggers vascular remodeling, and ultimately predisposes to right heart failure. Chronic hypoxia, thromboembolic disease, left heart valvular pathology, and obliterative vasculitides each converge on the common endpoint of increased PVR through distinct mechanistic pathways. Clinically, right heart catheterization remains the gold standard for PVR measurement, guiding diagnosis, prognostication, and therapeutic decision-making. Understanding the fundamental principles of PVR equips clinicians and investigators with the conceptual tools necessary to interpret hemodynamic data rationally and to design interventions that target the specific mechanical and molecular drivers of elevated pulmonary vascular resistance.</span></p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_20218781 |
| institution | Zenodo |
| language | |
| publishDate | 2026 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Pulmonary Vascular Resistance: Physiological Mechanisms, Pathophysiological Determinants, and Clinical Implications Indunil Karunarathna <p class="MsoNormal"><span>Pulmonary vascular resistance (PVR) represents a critical hemodynamic parameter governing right ventricular afterload, ventilation-perfusion matching, and gas exchange efficiency within the pulmonary circulation. Unlike the systemic circulation, where high resistance sustains arterial pressure, the pulmonary circuit operates as a low-resistance, high-capacitance system optimized to accommodate the entire cardiac output at mean pressures approximately one-tenth those of the systemic circulation. This review examines the physiological modeling of PVR through Ohm's and Poiseuille's laws, acknowledging their inherent limitations when applied to a pulsatile, non-Newtonian, and mechanically dynamic vascular bed. The mechanisms regulating PVR—including pulmonary intravascular pressure, lung volume, gravitational gradients, alveolar hypoxia, and smooth muscle tonicity—are explored in depth, emphasizing the integrated mechanical, biochemical, and neural control systems that maintain low resting resistance while preserving adaptive reserve. Pathophysiologically, sustained elevation of PVR drives pulmonary hypertension, triggers vascular remodeling, and ultimately predisposes to right heart failure. Chronic hypoxia, thromboembolic disease, left heart valvular pathology, and obliterative vasculitides each converge on the common endpoint of increased PVR through distinct mechanistic pathways. Clinically, right heart catheterization remains the gold standard for PVR measurement, guiding diagnosis, prognostication, and therapeutic decision-making. Understanding the fundamental principles of PVR equips clinicians and investigators with the conceptual tools necessary to interpret hemodynamic data rationally and to design interventions that target the specific mechanical and molecular drivers of elevated pulmonary vascular resistance.</span></p> |
| title | Pulmonary Vascular Resistance: Physiological Mechanisms, Pathophysiological Determinants, and Clinical Implications |
| url | https://doi.org/10.5281/zenodo.20218781 |