Early Development of Right Ventricular Ischemic Lesions in a Novel Large Animal Model of Acute Right Heart Failure in Chronic Thromboembolic Pulmonary Hypertension.

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Early Development of Right Ventricular Ischemic Lesions in a Novel Large Animal Model of Acute Right Heart Failure in Chronic Thromboembolic Pulmonary Hypertension.

J Card Fail. 2017 Aug 08;:

Authors: Boulate D, Ataam JA, Connolly AJ, Giraldeau G, Amsallem M, Decante B, Lamrani L, Fadel E, Dorfmuller P, Perros F, Haddad F, Mercier O

Abstract

BACKGROUND: Our aim was to develop a model of acute right heart failure (ARHF) in the setting of pulmonary hypertension and to characterize acute right ventricular lesions that develop early after hemodynamic restoration.

METHODS AND RESULTS: We used a described piglet model of chronic pulmonary hypertension (cPH) induced by pulmonary artery occlusions. We induced ARHF in animals with cPH (ARHF-cPH group, n=9) by volume loading and iterative acute pulmonary embolisms until hemodynamic compromise followed by dobutamine infusion for hemodynamic restoration prior to sacrifice for right ventricular tissue evaluation. The median duration of ARHF prior sacrifice was 162 (135-189) minutes. While ventriculo-arterial coupling (measured with multibeat pressure-volume loops) and stroke volume decreased after iterative pulmonary embolisms and improved with dobutamine; relative pulmonary to systemic pressure increased by twofold and remained similarly increased with dobutamine. Circulating high-sensitivity Troponin I increased after hemodynamic restoration. We found an increase in right ventricular subendocardial and subepicardial focal ischemic lesions and in expression of autophagy related protein LC3-II (Western blot) in the ARHF-cPH group compared to cPH (n=5) and control (n=5) groups.

CONCLUSIONS: We developed and phenotyped a novel large animal model of ARHF on cPH in which right ventricular ischemic lesions were observed early after hemodynamic restoration.

PMID: 28801076 [PubMed – as supplied by publisher]

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