Right ventricular adaptation to pulmonary hypertension: an interspecies comparison
Right ventricular adaptation to pulmonary hypertension: an interspecies comparison
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DOI：
10.1152/ajpheart.00640.2003
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发表时间：
2004-04-01
影响因子：
4.8
通讯作者：
Brimioulle, S
中科院分区：
文献类型：
--
作者：
Wauthy, P;Pagnamenta, A;Brimioulle, S
右心室（RV）适应是急慢性肺动脉高压的重要预后因素。已知不同物种间肺血管基底张力和缺氧反应性差异很大。我们研究了在低、中、高肺血管阻力和反应性的物种中，RV对急性肺动脉高压的适应性是如何保持的。在麻醉犬（n = 10）、山羊（n = 8）和猪（n = 8）中，通过缺氧、远端栓塞和近端收缩诱导急性肺动脉高压。通过流量压力曲线和阻抗来评估肺血管，以量化远端阻力、近端弹性和波反射。通过压力-容积曲线评估右心室功能，量化后负荷、收缩力和心室-动脉耦合效率。首先，从狗到山羊，从山羊到猪，缺氧与阻力、弹性和波反射的逐渐增加有关。RV收缩力随RV后负荷呈比例增加，所有物种均保持最优耦合。其次，栓塞增加了阻力和波反射，但没有增加弹性。右心室收缩力的增加与右心室后负荷的增加相匹配，保持了最佳耦合。最后，肺动脉近端收缩增加阻力，波反射增加和加速，弹性明显增加。右心室收缩力显著增加，耦合度呈不显著下降趋势。我们得出结论，无论是否存在慢性物种诱导的肺动脉高压，急性肺动脉高压均维持最佳或接近最佳的心室-动脉耦合。
Right ventricular ( RV) adaptation is an important prognostic factor in acute and chronic pulmonary hypertension. Pulmonary vascular basal tone and hypoxic reactivity are known to vary widely between species. We investigated how RV adaptation to acute pulmonary hypertension is preserved in species with low, intermediate, and high pulmonary vascular resistance and reactivity. Acute pulmonary hypertension was induced by hypoxia, distal embolism, and proximal constriction in anesthetized dogs ( n = 10), goats ( n = 8), and pigs ( n = 8). Pulmonary vessels were assessed by flow-pressure curves and by impedance to quantify distal resistance, proximal elastance, and wave reflections. RV function was assessed by pressure-volume curves to quantify afterload, contractility, and ventricular-arterial coupling efficiency. First, hypoxia was associated with a progressive increase of resistance, elastance, and wave reflection from dogs to goats and from goats to pigs. RV contractility increased proportionally to RV afterload, and optimal coupling was preserved in all species. Second, embolism increased resistance and wave reflection but not elastance. The increase in RV contractility matched the increase in RV afterload and optimal coupling was preserved. Finally, proximal pulmonary artery constriction increased resistance, increased and accelerated wave reflection, and markedly increased elastance. RV contractility increased markedly and coupling showed a nonsignificant trend to decrease. We conclude that optimal or near-optimal ventricular-arterial coupling is maintained in acute pulmonary hypertension, whether in absence or presence of chronic species-induced pulmonary hypertension.