Dodson R Blair, Morgan Matthew R, Galambos Csaba, Hunter Kendall S, Abman Steven H
Pediatric Heart Lung Center, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado; Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado; Department of Bioengineering, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado; and
Department of Biomedical Engineering, Duke University, Durham, North Carolina.
Am J Physiol Lung Cell Mol Physiol. 2014 Dec 1;307(11):L822-8. doi: 10.1152/ajplung.00256.2014. Epub 2014 Oct 17.
Persistent pulmonary hypertension of the newborn (PPHN) is a clinical syndrome that is characterized by high pulmonary vascular resistance due to changes in lung vascular growth, structure, and tone. PPHN has been primarily considered as a disease of the small pulmonary arteries (PA), but proximal vascular stiffness has been shown to be an important predictor of morbidity and mortality in other diseases associated with pulmonary hypertension (PH). The objective of this study is to characterize main PA (MPA) stiffness in experimental PPHN and to determine the relationship of altered biomechanics of the MPA with changes in extracellular matrix (ECM) content and orientation of collagen and elastin fibers. MPAs were isolated from control and PPHN fetal sheep model and were tested by planar biaxial testing to measure stiffness in circumferential and axial vessel orientations. Test specimens were fixed for histological assessments of the vascular wall ECM constituents collagen and elastin. MPAs from PPHN sheep had increased mechanical stiffness (P < 0.05) and altered ECM remodeling compared with control MPA. A constitutive mathematical model and histology demonstrated that PPHN vessels have a smaller contribution of elastin and a greater role for collagen fiber engagement compared with the control arteries. We conclude that exposure to chronic hemodynamic stress in late-gestation fetal sheep increases proximal PA stiffness and alters ECM remodeling. We speculate that proximal PA stiffness further contributes to increased right ventricular impedance in experimental PPHN, which contributes to abnormal transition of the pulmonary circulation at birth.
新生儿持续性肺动脉高压(PPHN)是一种临床综合征,其特征是由于肺血管生长、结构和张力的改变导致肺血管阻力升高。PPHN主要被认为是一种小肺动脉(PA)疾病,但近端血管僵硬已被证明是其他与肺动脉高压(PH)相关疾病发病和死亡的重要预测指标。本研究的目的是描述实验性PPHN中主肺动脉(MPA)的僵硬情况,并确定MPA生物力学改变与细胞外基质(ECM)含量以及胶原和弹性纤维取向变化之间的关系。从对照和PPHN胎羊模型中分离出MPA,并通过平面双轴测试来测量血管周向和轴向的僵硬程度。将测试标本固定以进行血管壁ECM成分胶原和弹性蛋白的组织学评估。与对照MPA相比,PPHN绵羊的MPA机械僵硬增加(P < 0.05),且ECM重塑改变。一个本构数学模型和组织学表明,与对照动脉相比,PPHN血管中弹性蛋白的贡献较小,胶原纤维参与的作用更大。我们得出结论,妊娠晚期胎羊暴露于慢性血流动力学应激会增加近端PA僵硬并改变ECM重塑。我们推测,近端PA僵硬进一步导致实验性PPHN中右心室阻抗增加,这有助于出生时肺循环的异常转变。