Right ventricular end-diastolic stiffness heralds right ventricular failure in monocrotaline-induced pulmonary hypertension

• Type: Article in International Scientific Journal
• Date: 2016

Authors

Alaa, M (Author) Other; Abdellatif, M (Author) Other; Tavares Silva, M (Author) FMUP; Oliveira Pinto, J (Author) FMUP; Lopes, L (Author) Other; Leite, S (Author) FMUP; Leite-Moreira AF (Author) FMUP; Andre P Lourenco (Author) FMUP

Journal

Title: American Journal of Physiology - Heart and Circulatory Physiology

Vol. 311

ISSN: 0363-6135

Publisher: American Physiological Society

Indexing

ISI Web of Knowledge - 16 Citations

Scopus - 16 Citations

Other information

Authenticus ID: P-00M-B8D

DOI: 10.1152/ajpheart.00202.2016

Abstract (EN): Recent studies suggest right ventricular (RV) stiffness is important in pulmonary hypertension (PH) prognosis. Smaller stroke volume (SV) variation after a certain RV end-diastolic pressure (EDP) respiratory variation as assessed by spectral transfer function (STF) may identify RV stiffness. Our aim was to evaluate RV stiffness in monocrotaline (MCT)-induced PH progression and to validate STF gain between EDP and SV as marker of stiffness. Seven-week-old male Wistar rats randomly injected with 60 mg/kg MCT or vehicle were divided into three groups (n 12 each) according to cardiac index (CI): controls (Ctrl), preserved CI (MCT pCI), and reduced CI (MCT rCI). All underwent RV pressure-volume (PV) evaluation 24-34 days after MCT, under halogenate anesthesia and constant positive-pressure ventilation. End-diastolic stiffness (beta(i)), end-systolic elastance (Ees(i)), arterial elastance for indexed volumes (Ea(i)), and preload recruitable stroke work (PRSW) were obtained and beat-to-beat fluctuations during ventilation assessed by STF. Eai was the strongest determinant of CI, alongside beta(i) but not PRSW. MCT rCI showed impaired ventricular-vascular coupling (VVC) and higher beta(i), along with low end-diastolic pressure (EDP) and stroke volume index (SVi) STF gain, denoting impaired preload reserve. On multivariate analysis beta(i) and not Eesi correlated with EDP-SVi STF gain (P < 0.001). Receiver-operating characteristics (ROC) curve analysis of EDP-SVi STF gain showed an area under curve of 0.84 for beta(i) prediction (P = 0.002). Afterload, impaired VVC and RV stiffness are major players in RV failure. RV stiffness can be assessed by STF gain analysis of respiratory fluctuations between EDP and SVi, which may constitute a prognostic tool in PH.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10