Right ventricular targeted gene transfer of a β-adrenergic receptor kinase inhibitor improves ventricular performance after pulmonary artery banding

Right ventricular (RV) failure due to chronic pressure overload is a main determinant of outcome in congenital heart disease. Medical management is challenging because not only contractility but also the interventricular relationship is important for increasing cardiac output. This study evaluated the effect of milrinone alone and in combination with epinephrine or dopamine on hemodynamics, ventricular performance, and the interventricular relationship. RV failure was induced in 21 Danish landrace pigs by pulmonary artery banding. After 10 wk, animals were reexamined using biventricular pressure-volume conductance catheters. The maximum pressure in the RV increased by 113% ( P < 0.0001) and end-diastolic volume by 43% ( P < 0.002), while left ventricular (LV) pressure simultaneously decreased ( P = 0.006). Concomitantly, mean arterial pressure (MAP; −16%, P = 0.01), cardiac index (CI; −23%, P < 0.0001), and mixed venous oxygen saturation (SvO2; −40%, P < 0.0001) decreased. Milrinone increased CI (11%, P = 0.008) and heart rate (HR; 21%, P < 0.0001). Stroke volume index (SVI) decreased (7%, P = 0.03), although RV contractility was improved. The addition of either epinephrine or dopamine further increased CI and HR in a dose-dependent manner but without any significant differences between the two interventions. A more pronounced increase in biventricular contractility was observed in the dopamine-treated animals. LV volume was reduced in both the dopamine and epinephrine groups with increasing doses In the failing pressure overloaded RV, milrinone improved CI and increased contractility. Albeit additional dose-dependent effects of both epinephrine and dopamine on CI and contractility, neither of the interventions improved SVI due to reduced filling of the LV.

Download Full-text

Midterm Ventricular Performance After Norwood Procedure With Right Ventricular–Pulmonary Artery Conduit

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2004.06.014 ◽

2004 ◽

Vol 78 (6) ◽

pp. 1965-1971 ◽

Cited By ~ 52

Author(s):

Yoshihisa Tanoue ◽

Hideaki Kado ◽

Yuichi Shiokawa ◽

Naoki Fusazaki ◽

Shiro Ishikawa

Keyword(s):

Pulmonary Artery ◽

Right Ventricular ◽

Norwood Procedure ◽

Ventricular Performance ◽

Artery Conduit

Download Full-text

The Hemodynamic Characteristics of Right Ventricle After Gradient Pulmonary Artery Banding in Rats

10.21203/rs.3.rs-49641/v1 ◽

2020 ◽

Author(s):

Song Jiyang ◽

Wan Nan ◽

Shen Shutong ◽

Wei Ying ◽

Cao Yunshan

Keyword(s):

Heart Failure ◽

Pulmonary Artery ◽

Right Ventricle ◽

Right Ventricular ◽

Right Heart Failure ◽

Therapeutic Strategies ◽

Pulmonary Artery Banding ◽

Right Heart ◽

Pulmonary Arterial ◽

The Right

Abstract Background: Right ventricular (RV) failure induced by sustained pressure overload is a major contributor to morbidity and mortality in several cardiopulmonary disorders. Reliable and reproducible animal models of RV failure are important in order to investigate disease mechanisms and effects of potential therapeutic strategies. To establish a rat model of RV failure perfectly, we observed the right ventricle and carotid artery hemodynamics characteristics in different degrees of pulmonary artery banding of rats of different body weights. Methods: Rats were subjected to 6 groups：control(0%, n=5)(pulmonary arterial banding 0%), PAB(1-30%, n=4)(pulmonary arterial banding1-30%), PAB(31-60%, n=6)(pulmonary arterial banding31-60%),PAB(61-70%, n=5)(pulmonary arterial bandin61-70%), PAB(71-80%,n=4)(pulmonary arterial banding71-80%), PAB(100%, n=3)(pulmonary arterial banding 100%). We measured the right ventricular pressure(RVP) by right heart catheterization when the pulmonary arterial was ligated. Results: The RVP gradually increased with increasing degree of banding, but when occlusion level exceeding 70%, high pressure state can be only maintained for a few minutes or seconds, and then the RVP drops rapidly until it falls below the normal pressure, which in Group F particularly evident.Conclusions: RVP have different reactions when the occlusion level is not the same, and the extent of more than 70% ligation is a successful model of acute right heart failure. These results may have important consequences for therapeutic strategies to prevent acute right heart failure.

Download Full-text