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Rothman A, Restrepo H, Evans WN, Sarukhanov V, Mann D. CAR Selectively Enhances the Pulmonary Vasodilatory Effect of Fasudil in a Microsphere Model of Pulmonary Hypertension. Open Respir Med J 2023; 17:e187430642303160. [PMID: 37916136 PMCID: PMC10351346 DOI: 10.2174/18743064-v17-e230404-2022-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/17/2023] [Accepted: 03/02/2023] [Indexed: 04/07/2023] Open
Abstract
Background Despite the approval of several medications for pulmonary hypertension, morbidity and mortality are unacceptably high. Systemic hypotension may limit the use of pulmonary hypertension medications. Objectives This study aimed to assess whether the homing peptide CAR (CARSKNKDC) improves the vasodilatory selectivity of fasudil in the pulmonary circulation or systemic circulation in a porcine pulmonary hypertension model. Materials and Methods Pulmonary hypertension (to approximately 2/3-3/4 systemic pressure levels) was induced by chronic and acute administration of microspheres in 3 micro Yucatan pigs (mean weight 19.9 kg, mean age 4.3 months). Fasudil (0.3 mg/kg) was administered without and with CAR (1.5 mg/kg), and the effect on aortic (Ao) and right ventricular (RV) pressure was recorded with indwelling catheters. Results Immediately after fasudil administration, there was a decrease in Ao pressure followed by prompt recovery to baseline. The RV pressure decrease was progressive and sustained. Fasudil alone resulted in a 12% decrease in RV pressure, whereas co-administration of CAR with fasudil resulted in a 22% decrease in RV pressure (p < 0.0001). Fasudil alone caused an average decrease of 34% in the RV/Ao pressure ratio, and fasudil + CAR caused an average decrease of 40% in the RV/Ao pressure ratio (p < 0.0001). Conclusion The homing peptide CAR selectively enhanced the acute vasodilatory effects of fasudil on the pulmonary vascular bed in a porcine experimental model of pulmonary hypertension.
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Affiliation(s)
- Abraham Rothman
- Children’s Heart Center, Nevada3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
- Department of Pediatrics, University of Nevada Las Vegas, School of Medicine, 2040 W Charleston Blvd Ste. 402, Las Vegas, NV 89109, USA
| | - Humberto Restrepo
- Children’s Heart Center, Nevada3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
- Department of Pediatrics, University of Nevada Las Vegas, School of Medicine, 2040 W Charleston Blvd Ste. 402, Las Vegas, NV 89109, USA
| | - William N. Evans
- Children’s Heart Center, Nevada3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
- Department of Pediatrics, University of Nevada Las Vegas, School of Medicine, 2040 W Charleston Blvd Ste. 402, Las Vegas, NV 89109, USA
| | - Valeri Sarukhanov
- Children’s Heart Center, Nevada3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
| | - David Mann
- Vascular BioSciences, 72 Santa Felicia Dr, Goleta, CA 93117, USA
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Berndt M, Buttenberg M, Graw JA. Large Animal Models for Simulating Physiology of Transfusion of Red Cell Concentrates-A Scoping Review of The Literature. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1735. [PMID: 36556937 PMCID: PMC9787038 DOI: 10.3390/medicina58121735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022]
Abstract
Background and Objectives: Transfusion of red cell concentrates is a key component of medical therapy. To investigate the complex transfusion-associated biochemical and physiological processes as well as potential risks for human recipients, animal models are of particular importance. This scoping review summarizes existing large animal transfusion models for their ability to model the physiology associated with the storage of erythrocyte concentrates. Materials and Methods: The electronic databases PubMed, EMBASE, and Web of Science were systematically searched for original studies providing information on the intravenous application of erythrocyte concentrates in porcine, ovine, and canine animal models. Results: A total of 36 studies were included in the analysis. The majority of porcine studies evaluated hemorrhagic shock conditions. Pig models showed high physiological similarities with regard to red cell physiology during early storage. Ovine and canine studies were found to model typical aspects of human red cell storage at 42 days. Only four studies provided data on 24 h in vivo survival of red cells. Conclusions: While ovine and canine models can mimic typical human erythrocyte storage for up to 42 days, porcine models stand out for reliably simulating double-hit pathologies such as hemorrhagic shock. Large animal models remain an important area of translational research since they have an impact on testing new pharmacological or biophysical interventions to attenuate storage-related adverse effects and allow, in a controlled environment, to study background and interventions in dynamic and severe disease conditions.
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Affiliation(s)
- Melanie Berndt
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité–Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Maximilian Buttenberg
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité–Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Jan A. Graw
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité–Universitätsmedizin Berlin, 13353 Berlin, Germany
- Department of Anesthesiology and Intensive Care Medicine, Ulm University, 89081 Ulm, Germany
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3
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Yuchi Y, Suzuki R, Kanno H, Teshima T, Matsumoto H, Koyama H. Right Ventricular Myocardial Adaptation Assessed by Two-Dimensional Speckle Tracking Echocardiography in Canine Models of Chronic Pulmonary Hypertension. Front Vet Sci 2021; 8:727155. [PMID: 34485446 PMCID: PMC8415444 DOI: 10.3389/fvets.2021.727155] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pulmonary hypertension (PH) is a life-threatening disease in dogs characterized by an increase in pulmonary arterial pressure (PAP) and/or pulmonary vascular resistance. Right ventricle adapts to its pressure overload through various right ventricular (RV) compensative mechanisms: adaptive and maladaptive remodeling. The former is characterized by concentric hypertrophy and increased compensatory myocardial contractility, whereas the latter is distinguished by eccentric hypertrophy associated with impaired myocardial function. Objectives: To evaluate the RV adaptation associated with the increase of PAP using two-dimensional speckle tracking echocardiography. Animals: Seven experimentally induced PH models. Methods: Dogs were anesthetized and then a pulmonary artery catheter was placed via the right jugular vein. Canine models of PH were induced by the repeated injection of microspheres through the catheter and monitored pulmonary artery pressure. Dogs were performed echocardiography and hemodynamic measurements in a conscious state when baseline and systolic PAP (sPAP) rose to 30, 40, 50 mmHg, and chronic phase. The chronic phase was defined that the sPAP was maintained at 50 mmHg or more for 4 weeks without injection of microspheres. Results: Pulmonary artery to aortic diameter ratio, RV area, end-diastolic RV wall thickness, and RV myocardial performance index were significantly increased in the chronic phase compared with that in the baseline. Tricuspid annular plane systolic excursion was significantly decreased in the chronic phase compared with that in the baseline. The RV longitudinal strain was significantly decreased in the sPAP30 phase, increased in the sPAP40 and sPAP50 phases, and decreased in the chronic phase. Conclusions: Changes in two-dimensional speckle tracking echocardiography-derived RV longitudinal strain might reflect the intrinsic RV myocardial contractility during the PH progression, which could not be detected by conventional echocardiographic parameters.
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Affiliation(s)
- Yunosuke Yuchi
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Ryohei Suzuki
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Haruka Kanno
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Takahiro Teshima
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hirotaka Matsumoto
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hidekazu Koyama
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
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4
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Goncharova NS, Andreeva EM, Vakhrushev AD, Leandro HIC, Murashova LA, Voronin SE, Korobchenko LE, Mitrofanova LB, Skorik YA, Galagudza MM, Moiseeva OM, Mikhaylov EN. Modeling of Acute Pulmonary Arterial Hypertension in Pigs Using a Stable Thromboxane A 2 Analogue (U46619): Dose Adjustment and Assessment of Hemodynamic Reactions. Bull Exp Biol Med 2021; 170:729-733. [PMID: 33893968 DOI: 10.1007/s10517-021-05142-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Indexed: 11/29/2022]
Abstract
U46619, a synthetic analogue of thromboxane A2 was used for modeling acute stable and reversible pulmonary arterial hypertension. Administration of U46619 in high doses led to vascular collapse and inhibition of cardiac function. The doses of U46619 were empirically selected that allow attaining the target level of pulmonary hypertension without systemic hemodynamic disturbances. The possibility of attaining the target level of pulmonary hypertension and reversibility of changes after termination of U46619 infusion make this model attractive for evaluation of the efficiency of different therapeutic methods of treatment of pulmonary hypertension in large animals.
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Affiliation(s)
- N S Goncharova
- Non-Coronary Heart Diseases Research Department, St. Petersburg, Russia.
| | - E M Andreeva
- Non-Coronary Heart Diseases Research Department, St. Petersburg, Russia
| | - A D Vakhrushev
- Neuromodulation Research Laboratory, St. Petersburg, Russia
| | | | - L A Murashova
- Center for Preclinical and Translational Research, St. Petersburg, Russia
| | - S E Voronin
- Center for Preclinical and Translational Research, St. Petersburg, Russia
| | | | - L B Mitrofanova
- Research Laboratory of Pathomorphology, V. A. Almazov National Medical Research Centre, Ministry of Health the Russian Federation, St. Petersburg, Russia
| | - Y A Skorik
- Center for Preclinical and Translational Research, St. Petersburg, Russia
| | - M M Galagudza
- Center for Preclinical and Translational Research, St. Petersburg, Russia
| | - O M Moiseeva
- Non-Coronary Heart Diseases Research Department, St. Petersburg, Russia
| | - E N Mikhaylov
- Neuromodulation Research Laboratory, St. Petersburg, Russia.,Arrhythmia Research Department, St. Petersburg, Russia
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5
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Stam K, Clauss S, Taverne YJHJ, Merkus D. Chronic Thromboembolic Pulmonary Hypertension - What Have We Learned From Large Animal Models. Front Cardiovasc Med 2021; 8:574360. [PMID: 33937352 PMCID: PMC8085273 DOI: 10.3389/fcvm.2021.574360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 03/08/2021] [Indexed: 12/21/2022] Open
Abstract
Chronic thrombo-embolic pulmonary hypertension (CTEPH) develops in a subset of patients after acute pulmonary embolism. In CTEPH, pulmonary vascular resistance, which is initially elevated due to the obstructions in the larger pulmonary arteries, is further increased by pulmonary microvascular remodeling. The increased afterload of the right ventricle (RV) leads to RV dilation and hypertrophy. This RV remodeling predisposes to arrhythmogenesis and RV failure. Yet, mechanisms involved in pulmonary microvascular remodeling, processes underlying the RV structural and functional adaptability in CTEPH as well as determinants of the susceptibility to arrhythmias such as atrial fibrillation in the context of CTEPH remain incompletely understood. Several large animal models with critical clinical features of human CTEPH and subsequent RV remodeling have relatively recently been developed in swine, sheep, and dogs. In this review we will discuss the current knowledge on the processes underlying development and progression of CTEPH, and on how animal models can help enlarge understanding of these processes.
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Affiliation(s)
- Kelly Stam
- Department of Cardiology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Yannick J H J Taverne
- Department of Cardiothoracic Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Daphne Merkus
- Department of Cardiology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance, Munich, Germany
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6
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Perros F, Ghigna MR, Loisel F, Chemla D, Decante B, de Montpreville V, Montani D, Humbert M, Fadel E, Mercier O, Boulate D. Description, Staging and Quantification of Pulmonary Artery Angiophagy in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension. Biomedicines 2020; 8:biomedicines8110493. [PMID: 33187154 PMCID: PMC7696066 DOI: 10.3390/biomedicines8110493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022] Open
Abstract
Angiophagy has been described as a non-fibrinolytic mechanism of pulmonary artery (PA) patency restoration after distal (<50 µm in diameter) pulmonary embolism in mice. We hypothesized that angiophagy could achieve muscularized PA patency restoration after pulmonary embolism in piglets and humans. Angiophagy was defined by pathological assessment as the moving of an embolic specimen from the lumen to the interstitium according to three stages in a pig model of chronic thromboembolic pulmonary hypertension (CTEPH) 6 to 10 weeks after embolization with enbucrilate: the embolic specimen is (I) covered by endothelial cells, (II) covered by endothelial cells and smooth muscle cells, and (III) located in the adventitia. In animals, we observed the three stages of the pulmonary angiophagy of enbucrilate emboli in <300 µm PA. Stages II and III were observed in 300 to 1000 μm PA, and only Stage I was observed in larger-diameter PA (>1000 μm). In lung samples from patients with histories of pulmonary embolisms, we observed PA angiophagy stigma for embolic specimens derived from blood clots and from bone marrow emboli. This study provides an original pathological description and staging of PA angiophagy in a large animal model of CTEPH and in humans after pulmonary embolism.
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Affiliation(s)
- Frédéric Perros
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
| | - Maria-Rosa Ghigna
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
- Research and Innovation Unit, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; (F.L.); (B.D.)
- Department of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France;
| | - Fanny Loisel
- Research and Innovation Unit, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; (F.L.); (B.D.)
| | - Denis Chemla
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- Department of Physiology, Hôpital Bicêtre, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - Benoit Decante
- Research and Innovation Unit, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; (F.L.); (B.D.)
| | | | - David Montani
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France
| | - Marc Humbert
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France
| | - Elie Fadel
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
- Research and Innovation Unit, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; (F.L.); (B.D.)
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350 Le Plessis Robinson, France
| | - Olaf Mercier
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
- Research and Innovation Unit, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; (F.L.); (B.D.)
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350 Le Plessis Robinson, France
| | - David Boulate
- School of Medicine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; (F.P.); (M.-R.G.); (D.C.); (D.M.); (M.H.); (E.F.); (O.M.)
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
- Research and Innovation Unit, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; (F.L.); (B.D.)
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350 Le Plessis Robinson, France
- Correspondence: ; Tel.: +33-140-948-725; Fax: +33-140-948-718
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The effect of sildenafil on pulmonary haemodynamics in a canine model of chronic embolic pulmonary hypertension. Res Vet Sci 2020; 133:106-110. [PMID: 32961474 DOI: 10.1016/j.rvsc.2020.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/08/2020] [Accepted: 08/30/2020] [Indexed: 01/07/2023]
Abstract
The effects of different doses of orally administered sildenafil on pulmonary haemodynamics in dogs with pulmonary hypertension (PH) have not been documented in an invasive and quantitative manner. In this study, we examined the effects of oral sildenafil using a canine model of chronic embolic PH (CEPH). This CEPH model was created by repeatedly injecting microspheres through a catheter into the pulmonary artery under general anaesthesia at regular weekly intervals over several months. The CEPH dogs received 1, 2 or 4 mg/kg of sildenafil orally twice a day for seven days. Then, haemodynamic measurements including pulmonary artery pressure (PAP), systemic artery pressure (SAP), pulmonary artery wedge pressure (PAWP), right atrial pressure (RAP) and cardiac output (CO) were obtained after seven days of sildenafil administration via right heart catheterisation and oscillometric blood pressure measurements. Sildenafil was well tolerated in this study. Sildenafil administered at doses of 2 and 4 mg/kg significantly decreased systolic PAP compared with before administration. In addition, all doses of sildenafil significantly decreased the mean and diastolic PAP. Furthermore, 4 mg/kg of sildenafil significantly decreased PAP compared with 1 mg/kg. Sildenafil also significantly decreased pulmonary vascular resistance without notable changes in SAP or systemic vascular resistance. The PAWP, RAP and CO did not increase significantly at any doses. In conclusion, the oral administration of sildenafil to CEPH models decreased PAP in a dose-dependent manner.
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Ogawa M, Ishizaka M, Akabane R, Sakatani A, Nagakawa M, Miyakawa H, Miyagawa Y, Takemura N. Evaluation of the Autonomic Nervous System in a Canine Model of Chronic Embolic Pulmonary Hypertension. Vet Res Commun 2020; 44:73-81. [PMID: 32500313 DOI: 10.1007/s11259-020-09774-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/30/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sildenafil improves autonomic dysfunction caused by pulmonary hypertension (PH) in humans, but its effect is unknown in dogs with PH. This prospective study aimed to evaluate the autonomic nervous system function of a canine model of chronic embolic PH (CEPH) and the autonomic nervous system function of a canine model of CEPH in which sildenafil was administered. METHODS This study used five clinically healthy female beagle dogs. Evaluation parameters included hemodynamic parameters, heart rate (HR) and heart rate variability (HRV). Each evaluation parameter was compared before and after creating the CEPH model (before, BL; after, CEPHBL) and between the CEPHBL model and after the administration of sildenafil (1 mg/kg, BID) in the CEPH model dogs (CEPHSil). RESULTS In the CEPHBL model, the hemodynamic parameters indicated cardiac hypofunction, and HR was significantly increased and HRV was significantly decreased compared with BL. Further, in the CEPHSil model, the hemodynamic parameters suggested improvement in cardiac function, and HRV was significantly increased. CONCLUSIONS From the results of the CEPH model dogs, autonomic dysfunction was shown to occur in PH dogs. In addition, the administration of 1 mg/kg of sildenafil to CEPH model dogs may improve autonomic dysfunction.
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Affiliation(s)
- Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan.
| | - Mio Ishizaka
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Ryota Akabane
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Atsushi Sakatani
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Masayoshi Nagakawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
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Wang L, Guo L, Zhu L, Sun Y, Zhang M, Xu Z. Characteristics of Pulmonary Vascular Remodeling in a Porcine Model of Shunt-Associated Pulmonary Arterial Hypertension. Pediatr Cardiol 2020; 41:669-676. [PMID: 31900509 DOI: 10.1007/s00246-019-02275-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 12/11/2019] [Indexed: 11/30/2022]
Abstract
Lung biopsy is the gold standard for evaluating pathological changes in the pulmonary vascular bed. Knowing the distribution characteristics of pulmonary vascular lesions can improve the accuracy of lung biopsy. To investigate the distribution characteristics of pulmonary vascular remodeling, a reliable porcine model of shunt-associated pulmonary arterial hypertension (PAH) was established. Twenty piglets were randomly divided into the experimental group (n = 10) and the control group (n = 10). A modified Blalock-Taussig shunt (MBTS, left innominate artery to main pulmonary artery) was created surgically in the experimental group. Three months later, an invasive catheter was used to obtain hemodynamic parameters, and lung biopsy was performed to assess the remodeling of pulmonary vascular bed. MBTS was successfully implemented in six piglets. There's no significant difference in hemodynamic parameters of the two groups before the shunt. However, these parameters and right ventricular hypertrophy index of the experimental group were significantly increased after three months shunting. Pathological changes in the experimental group, including thickening of pulmonary artery media, intimal fibrosis, and right ventricular hypertrophy, were observed. Furthermore, the percentage of media thickness and medial area of the experimental group were significantly higher than control group. Histopathology showed that vascular remodeling of the lung was inhomogeneous and that the lateral lesion was more severe than other segments. These results indicated that MBTS could be used to establish a reliable porcine model of shunt-associated PAH and that multisite detection with different segments should be applied to assess the severity of pulmonary vascular remodeling.
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Affiliation(s)
- Liping Wang
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Linlin Guo
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Limin Zhu
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Yanjun Sun
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Mingjie Zhang
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Zhuoming Xu
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China.
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Akabane R, Sato T, Sakatani A, Ogawa M, Nagakawa M, Miyakawa H, Miyagawa Y, Tazaki H, Takemura N. Pharmacokinetics of single dose sildenafil orally administered in canine models of chronic embolic pulmonary hypertension. J Vet Med Sci 2020; 82:446-451. [PMID: 32101822 PMCID: PMC7192714 DOI: 10.1292/jvms.19-0595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Information regarding the pharmacokinetics of oral sildenafil in dogs with pulmonary
hypertension is limited. In this study, we examined the pharmacokinetics of oral
sildenafil in a canine model of chronic embolic pulmonary hypertension (CEPH). The CEPH
model was developed by repeatedly injecting microspheres into the pulmonary arteries. The
pharmacokinetics of oral sildenafil at 1, 2 and 4 mg/kg was evaluated using four dogs with
pulmonary hypertension in the fasted state. The plasma concentrations of sildenafil were
determined using high-performance liquid chromatography, and pharmacokinetic parameters
were calculated using a noncompartmental analysis. Sildenafil was well tolerated in this
study. Proportional increments in the maximum plasma concentration and area under the
curve extrapolated to infinity at drug doses of 1, 2 and 4 mg/kg were detected using a
power model analysis. No significant differences were observed among the three doses in
the time to maximum plasma concentration. The mean residence time and elimination
half-life were slightly but significantly higher at a dose of 4 mg/kg than at a dose of 1
mg/kg.
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Affiliation(s)
- Ryota Akabane
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Touko Sato
- Laboratory of Biomolecular Chemistry, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Atsushi Sakatani
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Masayoshi Nagakawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Hiroyuki Tazaki
- Laboratory of Biomolecular Chemistry, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
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11
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Akabane R, Shimano S, Sakatani A, Ogawa M, Nagakawa M, Miyakawa H, Miyagawa Y, Takemura N. Relationship between right heart echocardiographic parameters and invasive pulmonary artery pressures in canine models of chronic embolic pulmonary hypertension. J Vet Med Sci 2019; 81:1485-1491. [PMID: 31484835 PMCID: PMC6863729 DOI: 10.1292/jvms.19-0350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Basic information related to the association between right heart echocardiographic
parameters and invasive pulmonary artery pressure (PAP) in dogs with pulmonary hypetension
(PH) is scarce. The aim of this study was to examine the association between conventional
right heart echocardiographic parameters and invasive PAP by right heart catheterization
(RHC) before and after PH. Five female beagle dogs regarded as clinically healthy were
used. Echocardiography and RHC were conducted before and after creating chronic embolic
pulmonary hypertension (CEPH) models. The acceleration time to ejection time ratio in
pulmonary artery flow profile (AT/ET), the ratio of the pulmonary artery and aortic
diameter in diastole (PA/Ao), the right pulmonary artery distensibility index by M-mode
method (RPAD M-mode), the normalized right ventricular internal diameter in
diastole (RVIDdn), and the normalized tricuspid annular plane systolic excursion (TAPSEn)
were correlated with the invasive systolic PAP (sPAP), mean PAP (mPAP) and diastolic PAP
(dPAP). Multiple linear regression analysis identified AT/ET and RVIDdn as independent
predictors of sPAP, PA/Ao and RVIDdn as independent predictors of mPAP, and PA/Ao and RPAD
M-mode as independent predictors of dPAP. AT/ET and PA/Ao had high
sensitivity and specificity for predicting CEPH. In conclusion, AT/ET, PA/Ao, RPAD
M-mode, RVIDdn and TAPSEn were significantly correlated with invasive PAP and
alterations in PA/Ao or AT/ET might enable clinicians to predict PH, even if tricuspid
regurgitation is not observed.
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Affiliation(s)
- Ryota Akabane
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Shotaro Shimano
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Atsushi Sakatani
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Masayoshi Nagakawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
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12
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Provencher S, Archer SL, Ramirez FD, Hibbert B, Paulin R, Boucherat O, Lacasse Y, Bonnet S. Standards and Methodological Rigor in Pulmonary Arterial Hypertension Preclinical and Translational Research. Circ Res 2019; 122:1021-1032. [PMID: 29599278 DOI: 10.1161/circresaha.117.312579] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Despite advances in our understanding of the pathophysiology and the management of pulmonary arterial hypertension (PAH), significant therapeutic gaps remain for this devastating disease. Yet, few innovative therapies beyond the traditional pathways of endothelial dysfunction have reached clinical trial phases in PAH. Although there are inherent limitations of the currently available models of PAH, the leaky pipeline of innovative therapies relates, in part, to flawed preclinical research methodology, including lack of rigour in trial design, incomplete invasive hemodynamic assessment, and lack of careful translational studies that replicate randomized controlled trials in humans with attention to adverse effects and benefits. Rigorous methodology should include the use of prespecified eligibility criteria, sample sizes that permit valid statistical analysis, randomization, blinded assessment of standardized outcomes, and transparent reporting of results. Better design and implementation of preclinical studies can minimize inherent flaws in the models of PAH, reduce the risk of bias, and enhance external validity and our ability to distinguish truly promising therapies form many false-positive or overstated leads. Ideally, preclinical studies should use advanced imaging, study several preclinical pulmonary hypertension models, or correlate rodent and human findings and consider the fate of the right ventricle, which is the major determinant of prognosis in human PAH. Although these principles are widely endorsed, empirical evidence suggests that such rigor is often lacking in pulmonary hypertension preclinical research. The present article discusses the pitfalls in the design of preclinical pulmonary hypertension trials and discusses opportunities to create preclinical trials with improved predictive value in guiding early-phase drug development in patients with PAH, which will need support not only from researchers, peer reviewers, and editors but also from academic institutions, funding agencies, and animal ethics authorities.
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Affiliation(s)
- Steeve Provencher
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada
| | - Stephen L Archer
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada
| | - F Daniel Ramirez
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada
| | - Benjamin Hibbert
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada
| | - Roxane Paulin
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada
| | - Olivier Boucherat
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada
| | - Yves Lacasse
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada
| | - Sébastien Bonnet
- From the Pulmonary Hypertension Research Group, Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., S.B.), Institut universitaire de cardiologie et de pneumologie de Québec Research Center (S.P., R.P., O.B., Y.L., S.B.), and Department of Medicine (S.P., R.P., O.B., Y.L., S.B.), Université Laval, Québec, Canada; Department of Medicine, Queen's University, Kingston, Canada (S.L.A.); Division of Cardiology (F.D.R., B.H.), CAPITAL Research Group (F.D.R., B.H.), and Vascular Biology and Experimental Medicine Laboratory (B.H.), University of Ottawa Heart Institute, Ontario, Canada; and Department of Cellular and Molecular Medicine (B.H.) and School of Epidemiology and Public Health (F.D.R.) University of Ottawa, Ontario, Canada.
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13
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Mulchrone A, Kellihan HB, Forouzan O, Hacker TA, Bates ML, Francois CJ, Chesler NC. A Large Animal Model of Right Ventricular Failure due to Chronic Thromboembolic Pulmonary Hypertension: A Focus on Function. Front Cardiovasc Med 2019; 5:189. [PMID: 30687717 PMCID: PMC6333696 DOI: 10.3389/fcvm.2018.00189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/13/2018] [Indexed: 11/13/2022] Open
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a debilitating disease that progresses to right ventricular (RV) failure and death if left untreated. Little is known regarding the progression of RV failure in this disease, greatly limiting effective prognoses, and therapeutic interventions. Large animal models enable the use of clinical techniques and technologies to assess progression and diagnose failure, but the existing large animal models of CTEPH have not been shown to replicate the functional consequences of the RV, i.e., RV failure. Here, we created a canine embolization model of CTEPH utilizing only microsphere injections, and we used a combination of right heart catheterization (RHC), echocardiography (echo), and magnetic resonance imaging (MRI) to quantify RV function. Over the course of several months, CTEPH led to a 6-fold increase in pulmonary vascular resistance (PVR) in four adult, male beagles. As evidenced by decreased cardiac index (0.12 ± 0.01 v. 0.07 ± 0.01 [L/(min*kg)]; p < 0.05), ejection fraction (0.48 ± 0.02 v. 0.31 ± 0.02; p < 0.05), and ventricular-vascular coupling ratio (0.95 ± 0.09 v. 0.45 ± 0.05; p < 0.05), as well as decreased tricuspid annular plane systolic excursion (TAPSE) (1.37 ± 0.06 v. 0.86 ± 0.05 [cm]; p < 0.05) and increased end-diastolic volume index (2.73 ± 0.06 v. 2.98 ± 0.02 [mL/kg]; p < 0.05), the model caused RV failure. The ability of this large animal CTEPH model to replicate the hemodynamic consequences of the human disease suggests that it could be utilized for future studies to gain insight into the pathophysiology of CTEPH development, following further optimization.
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Affiliation(s)
- Ashley Mulchrone
- Department of Biomedical Engineering, Univeristy of Wisconsin-Madison, Madison, WI, United States
| | - Heidi B Kellihan
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Omid Forouzan
- Department of Biomedical Engineering, Univeristy of Wisconsin-Madison, Madison, WI, United States
| | - Timothy A Hacker
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Melissa L Bates
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States.,Department of Pediatrics, University of Iowa, Iowa City, IA, United States
| | | | - Naomi C Chesler
- Department of Biomedical Engineering, Univeristy of Wisconsin-Madison, Madison, WI, United States.,Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States
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