Faber Matthijs J, Dalinghaus Michiel, Lankhuizen Inge M, Steendijk Paul, Hop Wim C, Schoemaker Regien G, Duncker Dirk J, Lamers Jos M J, Helbing Willem A
Erasmus MC, Sophia, Dept. of Pediatrics, Div. of Pediatric Cardiology, Rm. Sp-2429, Dr. Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands.
Am J Physiol Heart Circ Physiol. 2006 Oct;291(4):H1580-6. doi: 10.1152/ajpheart.00286.2006. Epub 2006 May 5.
In many patients with congenital heart disease, the right ventricle (RV) is subjected to abnormal loading conditions. To better understand the state of compensated RV hypertrophy, which could eventually progress to decompensation, we studied the effects of RV pressure overload in rats. In the present study, we report the biventricular adaptation to 6 wk of pulmonary artery banding (PAB). PAB resulted in an RV pressure overload to approximately 60% of systemic level and a twofold increase in RV mass (P < 0.01). Systemic hemodynamic parameters were not altered, and overt signs of heart failure were absent. Load-independent measures of ventricular function (end-systolic pressure-volume relation, preload recruitable stroke work relation, maximum first time derivative of pressure divided by end-diastolic volume), assessed by means of pressure-volume (PV) loops, demonstrated a two- to threefold increase in RV contractility under baseline conditions in PAB rats. RV contractility increased in response to dobutamine stimulation (2.5 microg.kg(-1).min(-1)) both in PAB and sham-operated rats in a similar fashion, indicating preserved RV contractile reserve in PAB rats. Left ventricular (LV) contractility at baseline was unaffected in PAB rats, although LV volume in PAB rats was slightly decreased. LV contractility increased in response to dobutamine (2.5 microg.kg(-1).min(-1)), both in PAB and sham rats, whereas the response to a higher dose of dobutamine (5 microg.kg(-1).min(-1)) was blunted in PAB rats. RV pressure overload (6 wk) in rats resulted in a state of compensated RV hypertrophy with preserved RV contractile reserve, whereas LV contractile state at baseline was not affected. Furthermore, this study demonstrates the feasibility of performing biventricular PV-loop measurements in rats.
在许多先天性心脏病患者中,右心室(RV)承受着异常的负荷状况。为了更好地理解代偿性右心室肥厚的状态,这种状态最终可能会发展为失代偿,我们研究了大鼠右心室压力超负荷的影响。在本研究中,我们报告了双心室对6周肺动脉环扎(PAB)的适应性变化。PAB导致右心室压力超负荷至全身水平的约60%,右心室质量增加两倍(P<0.01)。全身血流动力学参数未改变,且无明显心力衰竭迹象。通过压力-容积(PV)环评估的心室功能的负荷独立指标(收缩末期压力-容积关系、可募集前负荷的每搏功关系、压力的最大首次时间导数除以舒张末期容积)显示,在PAB大鼠的基线条件下右心室收缩力增加了两到三倍。在PAB大鼠和假手术大鼠中,多巴酚丁胺刺激(2.5μg·kg-1·min-1)均以类似方式使右心室收缩力增加,表明PAB大鼠保留了右心室收缩储备。PAB大鼠基线时左心室(LV)收缩力未受影响,尽管PAB大鼠的左心室容积略有减小。在PAB大鼠和假手术大鼠中,多巴酚丁胺(2.5μg·kg-1·min-1)均可使左心室收缩力增加,而PAB大鼠对更高剂量多巴酚丁胺(5μg·kg-1·min-1)的反应减弱。大鼠右心室压力超负荷(6周)导致代偿性右心室肥厚状态且保留了右心室收缩储备,而基线时左心室收缩状态未受影响。此外,本研究证明了在大鼠中进行双心室PV环测量的可行性。