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Alaa, M; Abdellatif, M; Tavares-Silva, M; Oliveira-Pinto, J; Lopes, L; Leite, S; Leite-Moreira, AF; Lourenço, AP.
Right ventricular end-diastolic stiffness heralds right ventricular failure in monocrotaline-induced pulmonary hypertension.
Am J Physiol Heart Circ Physiol. 2016; 311(4):H1004-H1013 Doi: 10.1152/ajpheart.00202.2016 [OPEN ACCESS]
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Leading authors Med Uni Graz: Abdellatif Mahmoud
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Abstract:: 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 (β_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. Ea_i was the strongest determinant of CI, alongside β_i but not PRSW. MCT rCI showed impaired ventricular-vascular coupling (VVC) and higher β_i, along with low end-diastolic pressure (EDP) and stroke volume index (SV_i) STF gain, denoting impaired preload reserve. On multivariate analysis β_i and not Ees_i correlated with EDP-SV_i STF gain (P < 0.001). Receiver-operating characteristics (ROC) curve analysis of EDP-SV_i STF gain showed an area under curve of 0.84 for β_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 SV_i, which may constitute a prognostic tool in PH. Copyright © 2016 the American Physiological Society.
Find related publications in this database (using NLM MeSH Indexing): Animals -; Diastole -; Elasticity -; Hypertension, Pulmonary - chemically induced; Hypertension, Pulmonary - physiopathology; Male -; Monocrotaline - toxicity; Multivariate Analysis -; ROC Curve -; Rats -; Rats, Wistar -; Stroke Volume -; Vascular Stiffness -; Ventricular Dysfunction, Right - physiopathology; Ventricular Pressure -
Find related publications in this database (Keywords): diastolic dysfunction; right ventricular failure; pulmonary hypertension; spectral transfer function analysis