TY - JOUR

T1 - Regional septal hinge-point injury contributes to adverse biventricular interactions in pulmonary hypertension

AU - Nielsen, Eva Amalie

AU - Okumura, Kenichi

AU - Sun, Mei

AU - Hjortdal, Vibeke E

AU - Redington, Andrew N

AU - Friedberg, Mark K

N1 - © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

PY - 2017/7

Y1 - 2017/7

N2 - Death and morbidity in pulmonary arterial hypertension (PAH) are often due to right ventricular (RV) failure and associated left ventricular (LV) dysfunction. We investigated regional myocardial remodeling and function as the basis for adverse ventricular-ventricular interactions in experimental chronic RV pressure overload. Two distinct animal models were studied: A rabbit model of increased RV pressure-load through progressive pulmonary artery banding A rat model of monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Regional myocardial function was assessed by speckle-tracking strain echocardiography and ventricular pressures measured by catheterization before termination. Regional RV and LV myocardium was analyzed for collagen content, apoptosis and pro-fibrotic signaling gene and protein expression. Although the RV developed more fibrosis than the LV; in both models the LV was substantially affected. In both ventricles, particularly the LV, fibrosis developed predominantly at the septal hinge-point regions in association with decreased regional and global circumferential strain, reduced global RV and LV function and up-regulation of regional transforming growth factor-β1 (TGFβ1) and apoptosis signaling. A group of PAH rats who received the TGFβ blocker SB431542 showed improved RV function and reduced regional hinge-point myocardial fibrosis. RV pressure-loading and PAH lead to biventricular TGFβ1 signaling, fibrosis and apoptosis, predominantly at the septal hinge-point regions, in association with regional myocardial dysfunction. This suggests that altered geometry and wall stress lead to adverse RV-LV interactions through the septal hinge-points to induce LV fibrosis and dysfunction.

AB - Death and morbidity in pulmonary arterial hypertension (PAH) are often due to right ventricular (RV) failure and associated left ventricular (LV) dysfunction. We investigated regional myocardial remodeling and function as the basis for adverse ventricular-ventricular interactions in experimental chronic RV pressure overload. Two distinct animal models were studied: A rabbit model of increased RV pressure-load through progressive pulmonary artery banding A rat model of monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Regional myocardial function was assessed by speckle-tracking strain echocardiography and ventricular pressures measured by catheterization before termination. Regional RV and LV myocardium was analyzed for collagen content, apoptosis and pro-fibrotic signaling gene and protein expression. Although the RV developed more fibrosis than the LV; in both models the LV was substantially affected. In both ventricles, particularly the LV, fibrosis developed predominantly at the septal hinge-point regions in association with decreased regional and global circumferential strain, reduced global RV and LV function and up-regulation of regional transforming growth factor-β1 (TGFβ1) and apoptosis signaling. A group of PAH rats who received the TGFβ blocker SB431542 showed improved RV function and reduced regional hinge-point myocardial fibrosis. RV pressure-loading and PAH lead to biventricular TGFβ1 signaling, fibrosis and apoptosis, predominantly at the septal hinge-point regions, in association with regional myocardial dysfunction. This suggests that altered geometry and wall stress lead to adverse RV-LV interactions through the septal hinge-points to induce LV fibrosis and dysfunction.

KW - Animals

KW - Apoptosis

KW - Collagen/genetics

KW - Echocardiography

KW - Fibrosis

KW - Heart Septum/diagnostic imaging

KW - Heart Ventricles/diagnostic imaging

KW - Hypertension, Pulmonary/diagnostic imaging

KW - Male

KW - Rabbits

KW - Rats

KW - Rats, Sprague-Dawley

KW - Transforming Growth Factor beta/metabolism

KW - Ventricular Dysfunction, Left/diagnostic imaging

KW - Ventricular Dysfunction, Right/diagnostic imaging

KW - Ventricular Remodeling

U2 - 10.14814/phy2.13332

DO - 10.14814/phy2.13332

M3 - Journal article

C2 - 28733311

VL - 5

JO - Physiological Reports

JF - Physiological Reports

SN - 2051-817X

IS - 14

M1 - e13332

ER -