Department of Bioengineering, University of California San Diego, La Jolla, California.
Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois.
Am J Physiol Heart Circ Physiol. 2021 Oct 1;321(4):H702-H715. doi: 10.1152/ajpheart.00046.2021. Epub 2021 Aug 27.
Although pulmonary arterial hypertension (PAH) leads to right ventricle (RV) hypertrophy and structural remodeling, the relative contributions of changes in myocardial geometric and mechanical properties to systolic and diastolic chamber dysfunction and their time courses remain unknown. Using measurements of RV hemodynamic and morphological changes over 10 wk in a male rat model of PAH and a mathematical model of RV mechanics, we discriminated the contributions of RV geometric remodeling and alterations of myocardial material properties to changes in systolic and diastolic chamber function. Significant and rapid RV hypertrophic wall thickening was sufficient to stabilize ejection fraction in response to increased pulmonary arterial pressure by without significant changes in systolic myofilament activation. After , RV end-diastolic pressure increased significantly with no corresponding changes in end-diastolic volume. Significant RV diastolic chamber stiffening by was not explained by RV hypertrophy. Instead, model analysis showed that the increases in RV end-diastolic chamber stiffness were entirely attributable to increased resting myocardial material stiffness that was not associated with significant myocardial fibrosis or changes in myocardial collagen content or type. These findings suggest that whereas systolic volume in this model of RV pressure overload is stabilized by early RV hypertrophy, diastolic dilation is prevented by subsequent resting myocardial stiffening. Using a novel combination of hemodynamic and morphological measurements over 10 wk in a male rat model of PAH and a mathematical model of RV mechanics, we found that compensated systolic function was almost entirely explained by RV hypertrophy, but subsequently altered RV end-diastolic mechanics were primarily explained by passive myocardial stiffening that was not associated with significant collagen extracellular matrix accumulation.
尽管肺动脉高压 (PAH) 导致右心室 (RV) 肥大和结构重塑,但心肌几何和力学特性的变化对收缩和舒张室功能障碍的相对贡献及其时间过程仍不清楚。在 PAH 雄性大鼠模型中,使用 10 周内 RV 血流动力学和形态变化的测量以及 RV 力学的数学模型,我们区分了 RV 几何重塑和心肌物质特性改变对收缩和舒张室功能变化的贡献。显著且快速的 RV 肥厚壁增厚足以通过 在没有收缩肌丝激活明显变化的情况下稳定射血分数。 后,RV 舒张末期压力显著增加,而舒张末期容积无相应变化。RV 舒张腔明显僵硬 通过 ,这不能用 RV 肥大来解释。相反,模型分析表明,RV 舒张末期腔僵硬的增加完全归因于静息心肌材料僵硬的增加,而静息心肌材料僵硬与显著的心肌纤维化或心肌胶原含量或类型的变化无关。这些发现表明,在这种 RV 压力超负荷模型中,虽然早期 RV 肥大稳定了收缩容积,但随后的静息心肌僵硬阻止了舒张扩张。使用 10 周内 PAH 雄性大鼠模型的血流动力学和形态测量的新组合以及 RV 力学的数学模型,我们发现代偿性收缩功能几乎完全由 RV 肥大解释,但随后改变的 RV 舒张末期力学主要由与明显胶原细胞外基质积累无关的被动心肌僵硬解释。