Department of Echocardiography, Xinjiang Key Laboratory of Medical Animal Model Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Neonatal Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Microvasc Res. 2021 May;135:104129. doi: 10.1016/j.mvr.2020.104129. Epub 2020 Dec 30.
Microcirculation disturbance is a crucial pathological basis of heart damage; however, microcirculation alterations induced by hypoxic pulmonary hypertension (HPH) remain unknown, and the left ventricle (LV) in HPH is conventionally ignored. Herein, we investigated the changes in the cardiac structure, function and microcirculation after HPH and further compared the differences between the right ventricle (RV) and LV. Using a neonatal rat model of HPH, we found RV myocardial hypertrophy, dysfunction and poor myocardial perfusion in HPH rats. Additionally, RV microcirculation disturbance manifested as the abnormal expression of endothelin-1/eNOS and increased expression of intercellular cell adhesion molecule-1 (ICAM-1) or E-selectin 3 days after hypoxia, followed by vascular inflammation, coronary arterial remodeling and microvascular sparseness. Impairment in LV vasodilation was detected in rats after 3 days of hypoxia; however, no obvious microvascular rarefaction or inflammatory reaction was observed in the LV. In conclusion, our results suggest that HPH mainly triggers RV microcirculation disturbances, causing low myocardial perfusion damage and cardiac dysfunction. Despite the differences in the RV and LV, their impaired microvascular function, mediated by endothelial cells, occurs almost simultaneously after HPH, earlier than cardiac functional or structural abnormalities.
微循环障碍是心脏损伤的重要病理基础;然而,缺氧性肺动脉高压(HPH)引起的微循环改变尚不清楚,且 HPH 中的左心室(LV)通常被忽略。在此,我们研究了 HPH 后心脏结构、功能和微循环的变化,并进一步比较了右心室(RV)和 LV 之间的差异。使用 HPH 的新生大鼠模型,我们发现 HPH 大鼠的 RV 心肌肥大、功能障碍和心肌灌注不良。此外,RV 微循环障碍表现为内皮素-1/eNOS 的异常表达,以及细胞间黏附分子-1(ICAM-1)或 E-选择素的表达增加,在缺氧 3 天后出现血管炎症、冠状动脉重构和微血管稀疏。在缺氧 3 天后的大鼠中检测到 LV 血管舒张受损;然而,在 LV 中未观察到明显的微血管稀疏或炎症反应。总之,我们的结果表明,HPH 主要引发 RV 微循环障碍,导致低心肌灌注损伤和心功能障碍。尽管 RV 和 LV 存在差异,但它们的微血管功能受损,由内皮细胞介导,在 HPH 后几乎同时发生,早于心功能或结构异常。