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School of Medicine
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Principal Investigator: Steven Hsu, MD
Johns Hopkins University School of Medicine
Ross Research Building, 8th Floor, 720 Rutland Avenue
Cardiovascular Cath Lab, 5th Floor, 1800 E. Orleans Street
Our work is focused on the translational human in vivo and ex vivo assessments of right ventricular (RV) function in the setting of pulmonary hypertension.
Among patients with group I pulmonary arterial hypertension PAH, those with systemic-sclerosis-associated PAH (SSc-PAH) have a particularly poor prognosis and less optimal response to PAH-guided therapy. Using in vivo pressure-volume catheterization of the right ventricle, we have uncovered key deficiencies in resting and reserve RV function in the SSc-PAH group when compared to idiopathic PAH (IPAH) patients. These studies have uncovered key discoveries with regards to right ventricular-pulmonary arterial (RV-PA) coupling in PAH. In the lab, by studying myofilament function from RV endomyocardial biopsies from these same patients, we have uncovered corresponding deficiencies in myofilament contractility and calcium sensitivity as well. Ongoing work is directed towards determining the underlying mechanism of these findings, which will hopefully lead to therapeutic applications for RV failure in SSc-PAH.
Further endeavors are directed towards studying RV failure in other populations, including exercise-induced PH, PH secondary to left-heart disease, and the left ventricular assist device population.
- Invasive in vivo RV pressure-volume loop assessments of RV dysfunction in PAH
- Myofilament and molecular studies of systemic sclerosis-PAH RV endomyocardial biopsy tissue
- Investigating non-invasive measures of RV-PA coupling in PH
- The study and clinical measurement of exercise-induced pulmonary hypertension
- Research studies investigating RV dysfunction in the left ventricular assist device population
- David A. Kass, MD
- Ryan J. Tedford, MD
- Monica Mukherjee, MD MPH
- Paul Hassoun, MD
- Stephen Mathai, MD MHS
- Rachel Damico, MD PhD
- Fredrick M. Wigley, MD
- Houston BA, Hsu S, Tampakakis E, Tedford RJ. The Right Ventricle: A Not-So-Innocent Bystander in Pulmonary Hypertension Due to Left Heart Disease. Advances in Pulmonary Hypertension. 2015;14:79-87.
- Hsu S, Houston BA, Tedford RJ. What is the Utility of Evaluating Patients for Exercise-Induced Pulmonary Hypertension? Ask the Expert Column. Advances in Pulmonary Hypertension. 2015;14:44-47.
- Houston BA, Kalathiya RJ, Hsu S, Loungani R, Davis ME, Coffin ST, Haglund N, Maltais S, Keebler ME, Leary PJ, Judge DP, Stevens GR, Rickard J, Sciortino CM, Whitman GJ, Shah AS, Russell SD, Tedford RJ. Right ventricular afterload sensitivity dramatically increases after left ventricular assist device implantation: a multi-center hemodynamic analysis. J Heart Lung Transpl. 2016;35:868-76.
- Hsu S, Houston BA, Tampakakis E, Bacher AC, Rhodes PS,Mathai SC,Damico RL,Kolb TM,Hummers LK,Shah AA, McMahan Z,Corona-Villalobos CP, Zimmerman SL,Wigley FM,Hassoun PM, Kass DA,Tedford RJ. Circulation. 2016;133:2413-22.
- Hsu S, Kass DA. Can Nitrites Amp up Sirt-anty to Treat Heart Failure with Preserved Ejection Fraction? Circulation. 2016;133:692-4.
- Metkus TS, Mullin CJ, Grandin EW, Rame JE, Tampakakis E, Hsu S, Kolb TM, Damico R, Hassoun PM, Kass DA, Mathai SC, Tedford RJ. Heart Rate Dependence of the Pulmonary Resistance x Compliance (RC) Time and Impact on Right Ventricular Load. PLoS One. 2016;11:e0166463.
- Hsu S, Brusca SB, Rhodes PS, Kolb TM, Mathai SC, Tedford RJ. Use of Thermodilution Cardiac Output Overestimates Diagnoses of Exercise-induced Pulmonary Hypertension. Pulmonary Circulation. 2017;7:253-255.
- Mullin CJ, Hsu S, Amancherla K, Wand A, Rhodes P, Leary PJ, Mukherjee M, Damico RL, Kolb TM, Mathai SC, Hassoun PM, Tedford RJ. Evaluation of criteria for exercise-induced pulmonary hypertension in patients with resting pulmonary hypertension. Eur Respir J. 2017;50(3):pii:1700784.
- Mukherjee M, Mercurio, V, Tedford RJ, Shah A, Hsu S, Mullin CJ, Sato T, Damico RL, Kolb TM, Mathai SC, Hassoun PM. Right Ventricular Longitudinal Strain is Diminished in Systemic Sclerosis Compared to Idiopathic Pulmonary Arterial Hypertension. Eur Respir J. 2017.