Right ventricular dysfunction is a central determinant of prognosis in pulmonary arterial hypertension, yet treatment options remain limited. Findings presented at the European Society of Cardiology (ESC) Congress 2025 suggest that integrin α5β1 signaling plays a critical role in maladaptive right ventricular remodeling.

Analysis of right ventricular tissue from patients with pulmonary arterial hypertension and corresponding animal models revealed elevated levels of integrins α5 and β1, with expression correlating with right ventricular dysfunction. Inhibition of integrin α5β1 reduced hypertrophy in cardiomyocytes, prevented fibroblast activation, and attenuated fibrosis.

In pulmonary artery banding rats, treatment with an α5β1-neutralizing antibody, alone or combined with sotatercept, improved cardiac output, right ventricular strain, and echocardiographic measures of function while reducing hypertrophy and fibrosis. Similar protective effects were observed in human precision-cut right ventricular slices.

These results indicate that integrin α5β1 is a key mediator of pathological right ventricular remodeling and may represent a promising therapeutic target in pulmonary arterial hypertension.