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Peter Van Trigt - One of the best experts on this subject based on the ideXlab platform.
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Molecular and functional mechanisms of right ventricular adaptation in Chronic Pulmonary Hypertension.
The Annals of thoracic surgery, 1999Co-Authors: Edward P. Chen, Shahab A. Akhter, Hartmuth B. Bittner, Walter J. Koch, R. Duane Davis, Peter Van TrigtAbstract:Abstract Background . Chronic Pulmonary Hypertension can lead to compensatory changes in the right ventricle. In this study, the adaptive mechanisms of the right ventricle in the setting of Pulmonary Hypertension were assessed at the molecular and functional level using a canine model of monocrotaline pyrrole–induced Pulmonary Hypertension. Methods . Animals underwent Pulmonary artery catheterization to measure Pulmonary hemodynamics before and 8 weeks after an injection of monocrotaline pyrrole, 3 mg/kg (n = 8) or placebo (n = 8) (controls). Systolic function was assessed with load-insensitive means (preload-recruitable stroke work). Myocardial biopsy specimens were collected to analyze membrane α 1 - and β-adrenergic receptor density and adenylate cyclase activity. Results . Eight weeks after injection, significant increases in Pulmonary hemodynamic indices were noted in monocrotaline-injected dogs. Significant increases in right ventricular preload-recruitable stroke work were also observed in these animals compared with controls and occurred in association with significant increases in right ventricular α 1 - and β-adrenergic receptor density and isoproterenol hydrochloride–stimulated adenylate cyclase activity. No significant differences in basal adenylate cyclase activity in the right ventricle were noted between the two groups. Conclusions . These data suggest that alterations in right ventricular function in the setting of Chronic Pulmonary Hypertension may partially be due to changes in myocardial adrenergic receptor signaling.
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Pharmacological Strategies for Improving Diastolic Dysfunction in the Setting of Chronic Pulmonary Hypertension
Circulation, 1998Co-Authors: Edward P. Chen, Hartmuth B. Bittner, Damian M. Craig, R. Duane Davis, Peter Van TrigtAbstract:Background—Right ventricular (RV) hypertrophy is an adaptive process that occurs in the setting of Chronic Pulmonary Hypertension (CPH) and can lead to alterations in normal RV diastolic properties. This study was designed to investigate the effects of NO and milrinone on RV diastolic dysfunction in the setting of CPH and RV hypertrophy by use of a canine model of monocrotaline pyrrole (MCTP)–induced CPH. Methods and Results—Sixteen mongrel dogs (22 to 24 kg) were used. Animals underwent percutaneous Pulmonary artery (PA) catheterization to measure Pulmonary hemodynamics before and 8 weeks after injection of 3 mg/kg MCTP (n=8) or placebo (control, n=8). Eight weeks after injection, all hearts were instrumented with a PA flow probe, sonomicrometric dimension transducers, and micromanometers. Data were collected at baseline and after both NO and milrinone administration. Diastolic properties were quantified by use of the end-diastolic pressure-volume relationship and the time constant of ventricular isovolu...
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Right ventricular failure--insights provided by a new model of Chronic Pulmonary Hypertension.
Transplantation, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, R. Duane Davis, Peter Van TrigtAbstract:This study was designed to examine the effects of both nitric oxide and milrinone on Pulmonary hemodynamics and right ventricular function using a newly established model of monocrotaline pyrrole-induced Chronic Pulmonary Hypertension. Sixteen mongrel dogs (23-25 kg) were used. All animals underwent per-cutanous Pulmonary artery catheterization to measure right heart hemodynamics prior to and 8 weeks after a right atrial injection of either monocrotaline pyrrole (MCTP, n=8) or placebo (CTL, n=8). Eight weeks postinjection, all hearts were instrumented with a Pulmonary artery flow probe and intracavitary micromanometers. Data were collected at baseline as well as following both nitric oxide and milrinone administration. There was no significant difference in the baseline hemodynamic measurements between the two groups. Eight weeks postinjection, significant increases in the Pulmonary artery pressure and Pulmonary vascular resistance were observed in MCTP compared with CTL. Both nitric oxide and milrinone resulted in significant improvements in Pulmonary vascular resistance, Pulmonary blood flow, and right ventricular contractility. In addition, nitric oxide caused a significant improvement in Pulmonary artery pressure and transPulmonary efficiency, while milrinone led to a significant increase in right ventricular hydraulic power. This study demonstrates the well-known clinical effects of nitric oxide and milrinone in improving Pulmonary Hypertension, which were also associated with an increase in Pulmonary blood flow, transPulmonary efficiency, and right ventricular hydraulic power in the setting of monocrotaline pyrrole-induced Chronic Pulmonary Hypertension.
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Nitric oxide improves Pulmonary vascular impedance, transPulmonary efficiency, and left ventricular filling in Chronic Pulmonary Hypertension.
The Journal of thoracic and cardiovascular surgery, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, Frank Tull, Damian M. Craig, R. Duane Davis, Peter Van TrigtAbstract:Abstract Objective: Chronic Pulmonary Hypertension is difficult to treat and despite the introduction of several therapeutic options, no single therapy is universally recommended. Nitric oxide has had some role clinically in improving Pulmonary hemodynamics in this setting; however, basic investigation has not been performed in an appropriate large animal model of stable Pulmonary Hypertension. This study was designed to examine the effects of inhaled nitric oxide on Pulmonary hemodynamics in the setting of a canine model of monocrotaline pyrrole–induced Chronic Pulmonary Hypertension and used Fourier analysis for assessment of Pulmonary vascular impedance. Methods: Sixteen mongrel dogs (22 to 25 kg) were used. Animals underwent percutaneous Pulmonary artery catheterization to measure right-sided hemodynamics before and 6 weeks after a right atrial injection of either monocrotaline pyrrole ( n = 8) or placebo ( n = 8). Six weeks after the injection all hearts were instrumented with an ultrasonic flow probe, sonomicrometric dimension transducers, and micromanometers. Data were collected at baseline and after nitric oxide administration. Harmonic derivation of functional data was achieved with Fourier analysis. Results: Six weeks after the injection, significant increases in Pulmonary artery pressure and Pulmonary vascular resistance were observed in the monocrotaline pyrrole group. Nitric oxide led to significant decreases in Pulmonary vascular impedance. Significant improvements in Pulmonary blood flow, transPulmonary efficiency, and left ventricular filling were also observed. Conclusions: This investigation demonstrates the well-known clinical effects of nitric oxide in improving Pulmonary Hypertension, which were also associated with an increase in Pulmonary blood flow, transPulmonary efficiency, and left ventricular filling in the setting of monocrotaline pyrrole–induced Pulmonary Hypertension. (J Thorac Cardiovasc Surg 1997;113:849-57)
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Pulmonary Hemodynamics and Blood Flow Characteristics in Chronic Pulmonary Hypertension
The Annals of thoracic surgery, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, Damian M. Craig, R. Duane Davis, Peter Van TrigtAbstract:Abstract Background . Lung transplantation is now an acceptable form of therapy for Pulmonary Hypertension, but controversy remains regarding the most appropriate surgical procedure. In this study, the changes in Pulmonary vascular mechanics occurring in the setting of Pulmonary Hypertension were investigated using an adult canine model of monocrotaline pyrrole–induced Pulmonary Hypertension. Methods . Animals underwent Pulmonary artery catheterization to measure right heart pressures before and 8 weeks after injection of either 3 mg/kg of monocrotaline pyrrole (n = 8) or placebo (n = 8). Eight weeks after injection, hearts underwent instrumentation with an ultrasonic flow probe and micromanometers. Harmonic derivation of functional data was achieved with Fourier analysis. Results . Significant increases in mean Pulmonary artery pressure and Pulmonary vascular resistance were observed after monocrotaline pyrrole injection. There was no significant difference in Pulmonary blood flow. However, significant increases in input resistance and right ventricular hydraulic power with significant decreases in transPulmonary efficiency were observed. Conclusions . Pulmonary Hypertension causes significant alterations in Pulmonary hemodynamics. Pulmonary blood flow is maintained by a significant increase in total power but with a significant decrease in transPulmonary efficiency. This adult canine model of Pulmonary Hypertension provides a useful means by which to evaluate surgical options of lung transplantation for improving Pulmonary hemodynamics in the setting of Chronic Pulmonary Hypertension.
Edward P. Chen - One of the best experts on this subject based on the ideXlab platform.
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Molecular and functional mechanisms of right ventricular adaptation in Chronic Pulmonary Hypertension.
The Annals of thoracic surgery, 1999Co-Authors: Edward P. Chen, Shahab A. Akhter, Hartmuth B. Bittner, Walter J. Koch, R. Duane Davis, Peter Van TrigtAbstract:Abstract Background . Chronic Pulmonary Hypertension can lead to compensatory changes in the right ventricle. In this study, the adaptive mechanisms of the right ventricle in the setting of Pulmonary Hypertension were assessed at the molecular and functional level using a canine model of monocrotaline pyrrole–induced Pulmonary Hypertension. Methods . Animals underwent Pulmonary artery catheterization to measure Pulmonary hemodynamics before and 8 weeks after an injection of monocrotaline pyrrole, 3 mg/kg (n = 8) or placebo (n = 8) (controls). Systolic function was assessed with load-insensitive means (preload-recruitable stroke work). Myocardial biopsy specimens were collected to analyze membrane α 1 - and β-adrenergic receptor density and adenylate cyclase activity. Results . Eight weeks after injection, significant increases in Pulmonary hemodynamic indices were noted in monocrotaline-injected dogs. Significant increases in right ventricular preload-recruitable stroke work were also observed in these animals compared with controls and occurred in association with significant increases in right ventricular α 1 - and β-adrenergic receptor density and isoproterenol hydrochloride–stimulated adenylate cyclase activity. No significant differences in basal adenylate cyclase activity in the right ventricle were noted between the two groups. Conclusions . These data suggest that alterations in right ventricular function in the setting of Chronic Pulmonary Hypertension may partially be due to changes in myocardial adrenergic receptor signaling.
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Pharmacological Strategies for Improving Diastolic Dysfunction in the Setting of Chronic Pulmonary Hypertension
Circulation, 1998Co-Authors: Edward P. Chen, Hartmuth B. Bittner, Damian M. Craig, R. Duane Davis, Peter Van TrigtAbstract:Background—Right ventricular (RV) hypertrophy is an adaptive process that occurs in the setting of Chronic Pulmonary Hypertension (CPH) and can lead to alterations in normal RV diastolic properties. This study was designed to investigate the effects of NO and milrinone on RV diastolic dysfunction in the setting of CPH and RV hypertrophy by use of a canine model of monocrotaline pyrrole (MCTP)–induced CPH. Methods and Results—Sixteen mongrel dogs (22 to 24 kg) were used. Animals underwent percutaneous Pulmonary artery (PA) catheterization to measure Pulmonary hemodynamics before and 8 weeks after injection of 3 mg/kg MCTP (n=8) or placebo (control, n=8). Eight weeks after injection, all hearts were instrumented with a PA flow probe, sonomicrometric dimension transducers, and micromanometers. Data were collected at baseline and after both NO and milrinone administration. Diastolic properties were quantified by use of the end-diastolic pressure-volume relationship and the time constant of ventricular isovolu...
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Right ventricular adaptation to increased afterload after orthotopic cardiac transplantation in the setting of recipient Chronic Pulmonary Hypertension.
Circulation, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, R. Duane Davis, P. Van TrigtAbstract:Right ventricular (RV) failure remains an important risk factor for early morbidity and mortality after orthotopic cardiac transplantation and is most commonly related to preexistent Chronic Pulmonary Hypertension (CPH) in the recipient, which occurs secondary to long-standing congestive heart failure. This study was designed to assess the compensatory mechanisms of the acutely transplanted RV in the setting of recipient CPH using a canine model of bicaval cardiac transplantation (TX) and monocrotaline pyrrole (MCTP)-induced CPH. Twenty adult mongrel dogs were used for 10 successfully completed TX experiments. Recipients received an injection of 3 mg/kg MCTP 4 months before TX. RV function was assessed with load-insensitive means (preload recruitable stroke work), and Fourier analysis was used to calculate RV hydraulic power and transPulmonary efficiency. At the time of TX, significant increases in the mean Pulmonary artery pressure, mean right ventricular pressure, and Pulmonary vascular resistance were observed in recipients compared with donors and were further significantly increased after cardioPulmonary bypass. Significant increases in RV preload recruitable stroke work and RV hydraulic power were observed after TX compared with before TX and occurred in association with significant decreases in transPulmonary efficiency. Significant increases in Pulmonary hemodynamic indexes occurred after MCTP injection and were further significantly increased after cardioPulmonary bypass. In the setting of recipient CPH, RV performance adapts acutely after bicaval TX with significant increases in power and contractility. However, a significant decrease in transPulmonary efficiency was also observed, which may improve over time as the RV adapts to the increased afterload.
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Right ventricular adaptation to increased afterload after orthotopic cardiac transplantation in the setting of recipient Chronic Pulmonary Hypertension.
Circulation, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, R. Duane Davis, P. Van TrigtAbstract:Background Right ventricular (RV) failure remains an important risk factor for early morbidity and mortality after orthotopic cardiac transplantation and is most commonly related to preexistent Chronic Pulmonary Hypertension (CPH) in the recipient, which occurs secondary to long-standing congestive heart failure. This study was designed to assess the compensatory mechanisms of the acutely transplanted RV in the setting of recipient CPH using a canine model of bicaval cardiac transplantation (TX) and monocrotaline pyrrole (MCTP)-induced CPH. Methods and Results Twenty adult mongrel dogs were used for 10 successfully completed TX experiments. Recipients received an injection of 3 mg/kg MCTP 4 months before TX. RV function was assessed with load-insensitive means (preload recruitable stroke work), and Fourier analysis was used to calculate RV hydraulic power and transPulmonary efficiency. At the time of TX, significant increases in the mean Pulmonary artery pressure, mean right ventricular pressure, and Pulmonary vascular resistance were observed in recipients compared with donors and were further significantly increased after cardioPulmonary bypass. Significant increases in RV preload recruitable stroke work and RV hydraulic power were observed after TX compared with before TX and occurred in association with significant decreases in transPulmonary efficiency. Conclusions Significant increases in Pulmonary hemodynamic indexes occurred after MCTP injection and were further significantly increased after cardioPulmonary bypass. In the setting of recipient CPH, RV performance adapts acutely after bicaval TX with significant increases in power and contractility. However, a significant decrease in transPulmonary efficiency was also observed, which may improve over time as the RV adapts to the increased afterload.
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Right ventricular failure--insights provided by a new model of Chronic Pulmonary Hypertension.
Transplantation, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, R. Duane Davis, Peter Van TrigtAbstract:This study was designed to examine the effects of both nitric oxide and milrinone on Pulmonary hemodynamics and right ventricular function using a newly established model of monocrotaline pyrrole-induced Chronic Pulmonary Hypertension. Sixteen mongrel dogs (23-25 kg) were used. All animals underwent per-cutanous Pulmonary artery catheterization to measure right heart hemodynamics prior to and 8 weeks after a right atrial injection of either monocrotaline pyrrole (MCTP, n=8) or placebo (CTL, n=8). Eight weeks postinjection, all hearts were instrumented with a Pulmonary artery flow probe and intracavitary micromanometers. Data were collected at baseline as well as following both nitric oxide and milrinone administration. There was no significant difference in the baseline hemodynamic measurements between the two groups. Eight weeks postinjection, significant increases in the Pulmonary artery pressure and Pulmonary vascular resistance were observed in MCTP compared with CTL. Both nitric oxide and milrinone resulted in significant improvements in Pulmonary vascular resistance, Pulmonary blood flow, and right ventricular contractility. In addition, nitric oxide caused a significant improvement in Pulmonary artery pressure and transPulmonary efficiency, while milrinone led to a significant increase in right ventricular hydraulic power. This study demonstrates the well-known clinical effects of nitric oxide and milrinone in improving Pulmonary Hypertension, which were also associated with an increase in Pulmonary blood flow, transPulmonary efficiency, and right ventricular hydraulic power in the setting of monocrotaline pyrrole-induced Chronic Pulmonary Hypertension.
Hartmuth B. Bittner - One of the best experts on this subject based on the ideXlab platform.
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Molecular and functional mechanisms of right ventricular adaptation in Chronic Pulmonary Hypertension.
The Annals of thoracic surgery, 1999Co-Authors: Edward P. Chen, Shahab A. Akhter, Hartmuth B. Bittner, Walter J. Koch, R. Duane Davis, Peter Van TrigtAbstract:Abstract Background . Chronic Pulmonary Hypertension can lead to compensatory changes in the right ventricle. In this study, the adaptive mechanisms of the right ventricle in the setting of Pulmonary Hypertension were assessed at the molecular and functional level using a canine model of monocrotaline pyrrole–induced Pulmonary Hypertension. Methods . Animals underwent Pulmonary artery catheterization to measure Pulmonary hemodynamics before and 8 weeks after an injection of monocrotaline pyrrole, 3 mg/kg (n = 8) or placebo (n = 8) (controls). Systolic function was assessed with load-insensitive means (preload-recruitable stroke work). Myocardial biopsy specimens were collected to analyze membrane α 1 - and β-adrenergic receptor density and adenylate cyclase activity. Results . Eight weeks after injection, significant increases in Pulmonary hemodynamic indices were noted in monocrotaline-injected dogs. Significant increases in right ventricular preload-recruitable stroke work were also observed in these animals compared with controls and occurred in association with significant increases in right ventricular α 1 - and β-adrenergic receptor density and isoproterenol hydrochloride–stimulated adenylate cyclase activity. No significant differences in basal adenylate cyclase activity in the right ventricle were noted between the two groups. Conclusions . These data suggest that alterations in right ventricular function in the setting of Chronic Pulmonary Hypertension may partially be due to changes in myocardial adrenergic receptor signaling.
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Pharmacological Strategies for Improving Diastolic Dysfunction in the Setting of Chronic Pulmonary Hypertension
Circulation, 1998Co-Authors: Edward P. Chen, Hartmuth B. Bittner, Damian M. Craig, R. Duane Davis, Peter Van TrigtAbstract:Background—Right ventricular (RV) hypertrophy is an adaptive process that occurs in the setting of Chronic Pulmonary Hypertension (CPH) and can lead to alterations in normal RV diastolic properties. This study was designed to investigate the effects of NO and milrinone on RV diastolic dysfunction in the setting of CPH and RV hypertrophy by use of a canine model of monocrotaline pyrrole (MCTP)–induced CPH. Methods and Results—Sixteen mongrel dogs (22 to 24 kg) were used. Animals underwent percutaneous Pulmonary artery (PA) catheterization to measure Pulmonary hemodynamics before and 8 weeks after injection of 3 mg/kg MCTP (n=8) or placebo (control, n=8). Eight weeks after injection, all hearts were instrumented with a PA flow probe, sonomicrometric dimension transducers, and micromanometers. Data were collected at baseline and after both NO and milrinone administration. Diastolic properties were quantified by use of the end-diastolic pressure-volume relationship and the time constant of ventricular isovolu...
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Right ventricular adaptation to increased afterload after orthotopic cardiac transplantation in the setting of recipient Chronic Pulmonary Hypertension.
Circulation, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, R. Duane Davis, P. Van TrigtAbstract:Right ventricular (RV) failure remains an important risk factor for early morbidity and mortality after orthotopic cardiac transplantation and is most commonly related to preexistent Chronic Pulmonary Hypertension (CPH) in the recipient, which occurs secondary to long-standing congestive heart failure. This study was designed to assess the compensatory mechanisms of the acutely transplanted RV in the setting of recipient CPH using a canine model of bicaval cardiac transplantation (TX) and monocrotaline pyrrole (MCTP)-induced CPH. Twenty adult mongrel dogs were used for 10 successfully completed TX experiments. Recipients received an injection of 3 mg/kg MCTP 4 months before TX. RV function was assessed with load-insensitive means (preload recruitable stroke work), and Fourier analysis was used to calculate RV hydraulic power and transPulmonary efficiency. At the time of TX, significant increases in the mean Pulmonary artery pressure, mean right ventricular pressure, and Pulmonary vascular resistance were observed in recipients compared with donors and were further significantly increased after cardioPulmonary bypass. Significant increases in RV preload recruitable stroke work and RV hydraulic power were observed after TX compared with before TX and occurred in association with significant decreases in transPulmonary efficiency. Significant increases in Pulmonary hemodynamic indexes occurred after MCTP injection and were further significantly increased after cardioPulmonary bypass. In the setting of recipient CPH, RV performance adapts acutely after bicaval TX with significant increases in power and contractility. However, a significant decrease in transPulmonary efficiency was also observed, which may improve over time as the RV adapts to the increased afterload.
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Right ventricular adaptation to increased afterload after orthotopic cardiac transplantation in the setting of recipient Chronic Pulmonary Hypertension.
Circulation, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, R. Duane Davis, P. Van TrigtAbstract:Background Right ventricular (RV) failure remains an important risk factor for early morbidity and mortality after orthotopic cardiac transplantation and is most commonly related to preexistent Chronic Pulmonary Hypertension (CPH) in the recipient, which occurs secondary to long-standing congestive heart failure. This study was designed to assess the compensatory mechanisms of the acutely transplanted RV in the setting of recipient CPH using a canine model of bicaval cardiac transplantation (TX) and monocrotaline pyrrole (MCTP)-induced CPH. Methods and Results Twenty adult mongrel dogs were used for 10 successfully completed TX experiments. Recipients received an injection of 3 mg/kg MCTP 4 months before TX. RV function was assessed with load-insensitive means (preload recruitable stroke work), and Fourier analysis was used to calculate RV hydraulic power and transPulmonary efficiency. At the time of TX, significant increases in the mean Pulmonary artery pressure, mean right ventricular pressure, and Pulmonary vascular resistance were observed in recipients compared with donors and were further significantly increased after cardioPulmonary bypass. Significant increases in RV preload recruitable stroke work and RV hydraulic power were observed after TX compared with before TX and occurred in association with significant decreases in transPulmonary efficiency. Conclusions Significant increases in Pulmonary hemodynamic indexes occurred after MCTP injection and were further significantly increased after cardioPulmonary bypass. In the setting of recipient CPH, RV performance adapts acutely after bicaval TX with significant increases in power and contractility. However, a significant decrease in transPulmonary efficiency was also observed, which may improve over time as the RV adapts to the increased afterload.
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Right ventricular failure--insights provided by a new model of Chronic Pulmonary Hypertension.
Transplantation, 1997Co-Authors: Edward P. Chen, Hartmuth B. Bittner, R. Duane Davis, Peter Van TrigtAbstract:This study was designed to examine the effects of both nitric oxide and milrinone on Pulmonary hemodynamics and right ventricular function using a newly established model of monocrotaline pyrrole-induced Chronic Pulmonary Hypertension. Sixteen mongrel dogs (23-25 kg) were used. All animals underwent per-cutanous Pulmonary artery catheterization to measure right heart hemodynamics prior to and 8 weeks after a right atrial injection of either monocrotaline pyrrole (MCTP, n=8) or placebo (CTL, n=8). Eight weeks postinjection, all hearts were instrumented with a Pulmonary artery flow probe and intracavitary micromanometers. Data were collected at baseline as well as following both nitric oxide and milrinone administration. There was no significant difference in the baseline hemodynamic measurements between the two groups. Eight weeks postinjection, significant increases in the Pulmonary artery pressure and Pulmonary vascular resistance were observed in MCTP compared with CTL. Both nitric oxide and milrinone resulted in significant improvements in Pulmonary vascular resistance, Pulmonary blood flow, and right ventricular contractility. In addition, nitric oxide caused a significant improvement in Pulmonary artery pressure and transPulmonary efficiency, while milrinone led to a significant increase in right ventricular hydraulic power. This study demonstrates the well-known clinical effects of nitric oxide and milrinone in improving Pulmonary Hypertension, which were also associated with an increase in Pulmonary blood flow, transPulmonary efficiency, and right ventricular hydraulic power in the setting of monocrotaline pyrrole-induced Chronic Pulmonary Hypertension.
Giovanni Truscelli - One of the best experts on this subject based on the ideXlab platform.
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three dimensional echocardiography and 2d 3d speckle tracking imaging in Chronic Pulmonary Hypertension diagnostic accuracy in detecting hemodynamic signs of right ventricular rv failure
Journal of the American Heart Association, 2015Co-Authors: Antonio Vitarelli, Enrico Mangieri, Claudio Terzano, Carlo Gaudio, Felice Salsano, Edoardo Rosato, Lidia Capotosto, Alessia Azzano, Simona Dorazio, Giovanni TruscelliAbstract:Background Our aim was to compare three‐dimensional (3D) and 2D and 3D speckle‐tracking (2D‐STE, 3D‐STE) echocardiographic parameters with conventional right ventricular (RV) indexes in patients with Chronic Pulmonary Hypertension (PH), and investigate whether these techniques could result in better correlation with hemodynamic variables indicative of heart failure. Methods and Results Seventy‐three adult patients (mean age, 53±13 years; 44% male) with Chronic PH of different etiologies were studied by echocardiography and cardiac catheterization (25 precapillary PH from Pulmonary arterial Hypertension, 23 obstructive Pulmonary heart disease, and 23 postcapillary PH from mitral regurgitation). Thirty healthy subjects (mean age, 54±15 years; 43% male) served as controls. Standard 2D measurements (RV–fractional area change–tricuspid annular plane systolic excursion) and mitral and tricuspid tissue Doppler annular velocities were obtained. RV 3D volumes and global and regional ejection fraction (3D‐RVEF) were determined. RV strains were calculated by 2D‐STE and 3D‐STE. RV 3D global‐free‐wall longitudinal strain (3DGFW‐RVLS), 2D global‐free‐wall longitudinal strain (GFW‐RVLS), apical‐free‐wall longitudinal strain, basal‐free‐wall longitudinal strain, and 3D‐RVEF were lower in patients with precapillary PH ( P <0.0001) and postcapillary PH ( P <0.01) compared to controls. 3DGFW‐RVLS (hazard ratio 4.6, 95% CI 2.79 to 8.38, P =0.004) and 3D‐RVEF (hazard ratio 5.3, 95% CI 2.85 to 9.89, P =0.002) were independent predictors of mortality. Receiver operating characteristic curves showed that the thresholds offering an adequate compromise between sensitivity and specificity for detecting hemodynamic signs of RV failure were 39% for 3D‐RVEF (AUC 0.89), −17% for 3DGFW‐RVLS (AUC 0.88), −18% for GFW‐RVLS (AUC 0.88), −16% for apical‐free‐wall longitudinal strain (AUC 0.85), 16 mm for tricuspid annular plane systolic excursion (AUC 0.67), and 38% for RV‐FAC (AUC 0.62). Conclusions In Chronic PH, 3D, 2D‐STE and 3D‐STE parameters indicate global and regional RV dysfunction that is associated with RV failure hemodynamics better than conventional echo indices.
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Three‐Dimensional Echocardiography and 2D‐3D Speckle‐Tracking Imaging in Chronic Pulmonary Hypertension: Diagnostic Accuracy in Detecting Hemodynamic Signs of Right Ventricular (RV) Failure
Journal of the American Heart Association, 2015Co-Authors: Antonio Vitarelli, Enrico Mangieri, Claudio Terzano, Carlo Gaudio, Felice Salsano, Edoardo Rosato, Lidia Capotosto, Simona D'orazio, Alessia Azzano, Giovanni TruscelliAbstract:Background Our aim was to compare three‐dimensional (3D) and 2D and 3D speckle‐tracking (2D‐STE, 3D‐STE) echocardiographic parameters with conventional right ventricular (RV) indexes in patients with Chronic Pulmonary Hypertension (PH), and investigate whether these techniques could result in better correlation with hemodynamic variables indicative of heart failure. Methods and Results Seventy‐three adult patients (mean age, 53±13 years; 44% male) with Chronic PH of different etiologies were studied by echocardiography and cardiac catheterization (25 precapillary PH from Pulmonary arterial Hypertension, 23 obstructive Pulmonary heart disease, and 23 postcapillary PH from mitral regurgitation). Thirty healthy subjects (mean age, 54±15 years; 43% male) served as controls. Standard 2D measurements (RV–fractional area change–tricuspid annular plane systolic excursion) and mitral and tricuspid tissue Doppler annular velocities were obtained. RV 3D volumes and global and regional ejection fraction (3D‐RVEF) were determined. RV strains were calculated by 2D‐STE and 3D‐STE. RV 3D global‐free‐wall longitudinal strain (3DGFW‐RVLS), 2D global‐free‐wall longitudinal strain (GFW‐RVLS), apical‐free‐wall longitudinal strain, basal‐free‐wall longitudinal strain, and 3D‐RVEF were lower in patients with precapillary PH ( P
Jin Zhao - One of the best experts on this subject based on the ideXlab platform.
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single intraperitoneal injection of monocrotaline as a novel large animal model of Chronic Pulmonary Hypertension in tibet minipigs
PLOS ONE, 2013Co-Authors: Guangqiao Zeng, Rong Liu, Haixing Liao, Xinfeng Zhang, Yuanxin Qian, Baohua Liu, Jin ZhaoAbstract:Objective The purpose of this study was to establish an animal model of Chronic Pulmonary Hypertension with a single-dose intraperitoneal injection of monocrotaline (MCT) in young Tibet minipigs, so as to enable both invasive and noninvasive measurements and hence facilitate future studies. Methods Twenty-four minipigs (8-week-old) were randomized to receive single-dose injection of 12.0 mg/kg MCT (MCT group, n = 12) or placebo (control group, n = 12 each). On day 42, all animals were evaluated for Pulmonary Hypertension with conventional transthoracic echocardiography, right heart catheterization (RHC), and pathological changes. Findings of these studies were compared between the two groups. Results At echocardiography, the MCT group showed significantly higher Pulmonary arterial mean pressure (PAMP) compared with the controls (P<0.001). The Pulmonary valve curve showed v-shaped signals with reduction of a-waves in minipigs treated with MCT. In addition, the MCT group had longer Pulmonary artery pre-ejection phases, and shorter acceleration time and ejection time. RHC revealed higher mean Pulmonary arterial pressure (mPAP) in the MCT group than in the control group (P<0.01). A significant and positive correlation between the mPAP values and the PAMP values (R = 0.974, P<0.0001), and a negative correlation between the mPAP and ejection time (R = 0.680, P<0.0001) was noted. Pathology demonstrated evidence of Pulmonary vascular remodeling and higer index of right ventricular hypertrophy in MCT-treated minipigs. Conclusion A Chronic Pulmonary Hypertension model can be successfully established in young minipigs at six weeks after MCT injection. These minipig models exhibited features of Pulmonary arterial Hypertension that can be evaluated by both invasive (RHC) and noninvasive (echocardiography) measurements, and may be used as an easy and stable tool for future studies on Pulmonary Hypertension.
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Single Intraperitoneal Injection of Monocrotaline as a Novel Large Animal Model of Chronic Pulmonary Hypertension in Tibet Minipigs
PloS one, 2013Co-Authors: Guangqiao Zeng, Rong Liu, Haixing Liao, Xinfeng Zhang, Yuanxin Qian, Baohua Liu, Jin ZhaoAbstract:Objective The purpose of this study was to establish an animal model of Chronic Pulmonary Hypertension with a single-dose intraperitoneal injection of monocrotaline (MCT) in young Tibet minipigs, so as to enable both invasive and noninvasive measurements and hence facilitate future studies. Methods Twenty-four minipigs (8-week-old) were randomized to receive single-dose injection of 12.0 mg/kg MCT (MCT group, n = 12) or placebo (control group, n = 12 each). On day 42, all animals were evaluated for Pulmonary Hypertension with conventional transthoracic echocardiography, right heart catheterization (RHC), and pathological changes. Findings of these studies were compared between the two groups. Results At echocardiography, the MCT group showed significantly higher Pulmonary arterial mean pressure (PAMP) compared with the controls (P