The importance of capillary density-stroke work mismatch for right ventricular adaptation to chronic pressure overload
| Autor: | Peter Dorfmüller, Benoit Decante, Olaf Mercier, Fanny Loisel, Lilia Lamrani, Jennifer Arthur-Ataam, Nathaniel B. Langer, Pierre-Emmanuel Noly, Elie Fadel, Francois Haddad, Julien Guihaire |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Time Factors Heart Ventricles Hypertension Pulmonary Ventricular Dysfunction Right Sus scrofa Hemodynamics 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Fibrosis Internal medicine medicine.artery medicine Animals Angiogenic Proteins Ventricular remodeling Pressure overload Hypertrophy Right Ventricular Neovascularization Pathologic Ventricular Remodeling business.industry medicine.disease Pulmonary hypertension Adaptation Physiological Capillaries Disease Models Animal 030228 respiratory system Animals Newborn Eisenmenger syndrome Pulmonary artery Chronic Disease Cardiology Ventricular Function Right Surgery Myocardial fibrosis Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 154(6) |
| ISSN: | 1097-685X |
| Popis: | Objective Mechanisms of right ventricular (RV) adaptation to chronic pressure overload are not well understood. We hypothesized that a lower capillary density (CD) to stroke work ratio would be associated with more fibrosis and RV maladaptive remodeling. Methods We induced RV chronic pressure overload over a 20-week period in 2 piglet models of pulmonary hypertension; that is, a shunt model (n = 5) and a chronic thromboembolic pulmonary hypertension model (n = 5). We assessed hemodynamic parameters and RV remodeling as well as RV CD, fibrosis, and angiogenic factors expression. Results Although RV was similarly hypertrophied in both models, maladapted RV remodeling with impaired systolic function was only seen in chronic thromboembolic pulmonary hypertension group members who had lower CD (484 ± 99 vs 1213 ± 74 cap/mm 2 ; P P = .02), higher myocardial fibrosis (15.4% ± 3.8% vs 8.0% ± 2.5%; P Conclusions The RV adaptive response to chronic pressure overload differs between 2 different piglet models of PH. Mismatch between angiogenesis and workload (CD to stroke work ratio) was associated with greater degree of myocardial fibrosis and RV dysfunction and could be a promising index of RV maladaptation. Further studies are needed to understand the underlying mechanisms. |
| Databáze: | OpenAIRE |
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