Abstract
Although extensively used for the study of left ventricular function, limited experience exists with the isolated heart model in the evaluation of right ventricular (RV) function. In particular, no published experience exists with this tool in sugen/hypoxia‐induced pulmonary hypertension (SuHx‐PH), a frequently used model of severe and progressive PH. We sought to characterize markers of RV contractile and diastolic function in SuHx‐PH and to establish their relationship with markers of maladaptive RV remodeling. Hearts were excised from anesthetized Sprague Dawley rats with or without SuHx‐PH and perfused via the aorta using a Langendorff preparation. We explored the Frank–Starling relationship of RV function (RV developed pressure, dP/dt max, and dP/dt min; all normalized to RV mass) by increasing RV end‐diastolic pressure (RVEDP) from 0 to 40 mmHg. Functional studies were complemented by quantification of RV pro‐apoptotic signaling (bcl2/bax), procontractile signaling (apelin), and stress response signaling (p38MAPK activation). Pearson's correlation analysis was performed for functional and biochemical parameters. SuHx‐RVs exhibited severe RV dysfunction with marked hypertrophy and decreased echocardiographic cardiac output. For any given RVEDP, SuHx‐RVs demonstrated less developed pressure and lower dP/dt max, as well as less pronounced dP/dt min, suggestive of decreased contractile and diastolic function. SuHx‐RVs exhibited decreased bcl2/bax ratios, apelin expression, and p38MAPK activation. Bcl2/bax and apelin RNA abundance correlated positively with RV developed pressure and dP/dt max and negatively with dP/dt min. p38MAPK activation correlated positively with RV developed pressure. We conclude that SuHx‐RVs exhibit severe contractile and diastolic dysfunction. Increased pro‐apoptotic signaling and attenuated procontractile and stress response signaling may contribute to these functional alterations.
Highlights
Pulmonary arterial hypertension (PAH) is a progressive and devastating disease characterized by muscularization, dysregulated vasoconstriction, and formation of occlusive lesions in the pulmonary arteries (Rabinovitch 2012; Tuder et al 2013a,b)
We report a decrease in right ventricular (RV) contractile and diastolic function in SuHx-RVs and demonstrate novel correlations between changes in RV contractile and diastolic function and alterations in bcl-2/bax and apelin expression as well as p38MAPK activation
We demonstrate robust decreases in RV contractile and diastolic function
Summary
Pulmonary arterial hypertension (PAH) is a progressive and devastating disease characterized by muscularization, dysregulated vasoconstriction, and formation of occlusive lesions in the pulmonary arteries (Rabinovitch 2012; Tuder et al 2013a,b). These changes lead to increased right ventricular (RV) afterload and, if left untreated, RV failure and death (Rabinovitch 2012; Tuder et al 2013a,b).
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