Modeling Pulmonary Hypertension: A Pig Model of Postcapillary Pulmonary Hypertension

Autors de IIS La Fe

• Iratxe Zarragoikoetxea Jauregui

  Autor

• Jaume Agüero Ramón-Llin

  Autor

Autors aliens a IIS La Fe

• Bikou O
• Ishikawa K
• Fish KM
• Hajjar RJ

Grups d'Investigació

• Anestesia y Cuidados Críticos

  Investigador Principal

  María Azucena Pajares Moncho

• Grupo de Investigación Clínica y Traslacional en Cardiología

  

  Investigador Principal

  Esther Roselló Lletí

Abstract

Pulmonary hypertension (PH) is a pathophysiological condition defined as an increase in mean pulmonary arterial pressure >= 25 mmHg at rest assessed by right heart catheterization. Based on hemodynamic criteria, precapillary PH is characterized by a mean pulmonary capillary wedge pressure <= 15 mmHg as opposed to the postcapillary PH by > 15 mmHg. Postcapillary PH is one of the most common forms of PH, often caused by left ventricular dysfunction and heart failure. In this chapter, we describe protocols for creating a large animal model of postcapillary PH. It is induced by open chest surgery (lateral thoracotomy) to band the pulmonary veins. The model is characterized by low mortality, relatively easy surgical procedure with well reproducible results, and pulmonary and cardiac remodeling at the structural, functional, and molecular levels. The presence of right ventricular (RV) remodeling is of significant importance since right heart failure is the main cause of death in patients suffering from PH. One of the advantages of the model described in this chapter is that both adaptive and maladaptive forms of RV remodeling can be observed during the progression of the disease. This can help understand the progressive pathophysiology of RV failure in humans. Besides the description of the model, a detailed guidance of the RV functional assessment in pigs for both invasive (heart catheterization) and noninvasive (echocardiography) approaches is provided.

Keywords

• Pulmonary hypertension; Animal model; Large animal; Postcapillary pulmonary hypertension; Right heart failure; Right heart echocardiography