Metabolic Alterations Associated With Right Ventricular Dysfunction in Pulmonary Arterial Hypertension: The Modulatory Effects and Improvement Mechanisms of Exercise.

Pulmonary arterial hypertension (PAH) is characterized by a significant increase in pulmonary arterial pressure, leading to right ventricular failure (RVF), limited exercise capacity, and increased mortality risk. Right ventricular function is a critical determinant of exercise capacity and prognosis in patients with PAH. Meanwhile, alterations in cellular metabolism and bioenergy are common features in PAH, with the differential regulation of metabolic pathways playing a significant role in right ventricular dysfunction (RVD).