Author + information
- Marinus Alexander Borgdorff,
- Beatrijs Bartelds,
- Michael Dickinson,
- Paul Steendijk,
- Maartje de Vroomen and
- Rolf Berger
Right ventricular failure (RVF) is a main determinant of outcome in congenital heart diseases and pulmonary hypertension. Unfortunately, little is known about its causes. Our aim was to study the pathophysiology of RVF by comparing rats with clinical RVF to rats without clinical RVF, in a model of chronic pressure load.
Methods and Results
Wistar rats were subjected to pulmonary artery banding (1.1mm) and then daily checked for clinical signs of RVF (inactivity, ruffled fur, dyspnea, ascites). Clinical RVF ensued after a period of 52±5 days in 56% of rats. At the onset of clinical RVF (necessitating termination), echocardiography and pressure-volume analysis were performed in those with RVF and in paired compensated rats (noRVF). Pressure load was equal in RVF and noRVF (table). In clinical RVF, cardiac index and TAPSE were lower than in noRVF. RVF rats had pericardial effusion, liver congestion, and dilated right atria, in contrast to noRVF rats. Hemodynamically, RVF rats showed preserved contractility (end systolic elastance), but severe diastolic dysfunction (end diastolic elastance, end diastolic pressure). While RV hypertrophy was equal in both groups, interestingly, myocardial fibrosis was significantly higher in noRVF, which suggests that fibrosis might be protective.
Chronic pressure load is sufficient to induce RVF, but not via excessive hypertrophy or fibrosis. RVF is characterized by diastolic failure, thus improving diastolic function may be the key to treating RVF.
|RV peak pressure (mmHg)||25±1||69±6*||73±4*|
|Cardiac index (mL/min/g)||0.32±0.01||0.19±0.02*||0.11±0.02*,#|
|End systolic elastance (mmHg/mL)||40±3||101±21*||269±77*|
|End diastolic elastance (mmHg/cL)||19±1||114±17*||323±95*,#|
|End diastolic pressure (mmHg)||1±0||3±1*||6±1*,#|
|RV fibrosis ($$)||5±1||29±3*||16±2*,#|
|RV hypertrophy (mg/g)||0.6±0.1||1.4±0.1*||1.3±0.1*|
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Cardiology Solutions: Congenital Imaging
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1160-115
- 2013 American College of Cardiology Foundation