Document Detail

Right ventricular failure secondary to chronic overload in congenital heart disease: an experimental model for therapeutic innovation.
MedLine Citation:
PMID:  20412956     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Mortality and morbidity related to right ventricular failure remain a problem for the long-term outcome of congenital heart diseases. Therapeutic innovation requires establishing an animal model reproducing right ventricular dysfunction secondary to chronic pressure-volume overload. METHODS: Right ventricular tract enlargement by transvalvular patch and pulmonary artery banding were created in 2-month-old piglets (n = 6) to mimic repaired tetralogy of Fallot. Age-matched piglets were used as controls (n = 5). Right ventricular function was evaluated at baseline and 3 and 4 months of follow-up by hemodynamic parameters and electrocardiography. Right ventricular tissue remodeling was characterized using cellular electrophysiologic and histologic analyses. RESULTS: Four months after surgery, right ventricular peak pressure increased to 75% of systemic pressure and pulmonary regurgitation significantly progressed, end-systolic and end-diastolic volumes significantly increased, and efficient ejection fraction significantly decreased compared with controls. At 3 months, the slope of the end-systolic pressure-volume relationship was significantly elevated compared with baseline and controls; a significant rightward shift of the slope, returning to the baseline value, was observed at 4 months, whereas stroke work progressed at each step and was significantly higher than in controls. Four months after surgery, QRS duration was significantly prolonged as action potential duration. Significant fibrosis and myocyte hypertrophy without myolysis and inflammation were observed in the operated group at 4 months. CONCLUSION: Various aspects of early right ventricular remodeling were analyzed in this model. This model reproduced evolving right ventricular alterations secondary to chronic volumetric and barometric overload, as observed in repaired tetralogy of Fallot with usual sequelae, and can be used for therapeutic innovation.
Virginie Lambert; Andr? Capderou; Emmanuel Le Bret; Catherine R?cker-Martin; Edith Deroubaix; Elodie Gouadon; Nicolas Raymond; Bertrand Stos; Alain Serraf; Jean-Fran?ois Renaud
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  139     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-23     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1197-204, 1204.e1     Citation Subset:  AIM; IM    
Copyright Information:
2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
D?partement de Recherche M?dicale, CNRS UMR 8162, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.
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MeSH Terms
Action Potentials
Animals, Newborn
Blood Pressure
Cardiac Surgical Procedures / adverse effects*
Disease Models, Animal
Electrophysiologic Techniques, Cardiac
Heart Conduction System / physiopathology
Heart Failure / etiology*,  pathology,  physiopathology,  therapy
Hypertrophy, Right Ventricular / etiology,  physiopathology
Myocytes, Cardiac / pathology
Reproducibility of Results
Stroke Volume
Tetralogy of Fallot / complications,  pathology,  physiopathology,  surgery*
Time Factors
Ventricular Dysfunction, Right / etiology*,  pathology,  physiopathology,  therapy
Ventricular Function, Right*
Ventricular Pressure
Ventricular Remodeling

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