A Rabbit Model Of Progressive Chronic Right Ventricular Pressure Overload

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY(2018)

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摘要
OBJECTIVES: Right ventricular (RV) failure from increased pressure loading is a frequent consequence of acquired and congenital heart diseases. However, the mechanisms involved in their pathophysiology are still unclear, and few data exist on RV pressure-loading models and early versus late effects on RV and left ventricular responses. We characterized a rabbit model of chronic RV pressure overload and early-late effects on biventricular function.METHODS: Twenty-one New Zealand white rabbits were randomized into 3 groups: (i) sham, (ii) pulmonary artery (PA) banding (PAB) for 3 weeks (PAB3W) and (iii) PAB for 6 weeks (PAB6W). Progressive RV pressure overload was created by serial band inflation using an adjustable device. Molecular, echocardiographic and haemodynamic studies were performed.RESULTS: RV pressure overload was achieved with clinical manifestations of RV failure. Heart and liver weights were significantly higher after PAB. PAB-induced echocardiographic ventricular remodelling increased wall thickness and stress and ventricular dilation. Cardiac output (ml/min) (sham 172.4 +/- 42.86 vs PAB3W 103.1 +/- 23.14 vs PAB6W 144 +/- 60.9, P = 0.0027) and systolic and diastolic functions decreased; with increased RV end-systolic and end-diastolic pressures (mmHg) (sham 1.6 +/- 0.66 vs PAB3W 3.9 +/- 1.8 vs PAB6W 5.2 +/- 2.2, P = 0.0103), despite increased contractility [end-systolic pressure-volume relationship (mmHg/ml), sham 3.76 +/- 1.76 vs PAB3W 12.21 +/- 3.44 vs PAB6W 19.4 +/- 6.88, P < 0.0001]. Functional parameters further worsened after PAB6W versus PAB3W. LV contractility increased in both the PAB groups, despite worsening of other invasive measures of systolic and diastolic functions.CONCLUSIONS: We describe a novel, unique model of chronic RV pressure overload leading to early biventricular dysfunction and fibrosis with further progression at 6 weeks. These findings can aid in guiding management.
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关键词
Right heart failure, Pressure-volume curves, Interventricular interactions, Ventricular fibrosis and remodelling, Animal model of right heart failure
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