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。 2015Nov 4;(105):e53133.
doi: 10.3791/53133.

慢性血栓栓塞性肺动脉高压和小猪中右心功能的评估

皮埃尔·埃曼纽尔·诺伊（Pierre-Emmanuel Noly）1，，，， Julien Guihaire2，，，， Matthieu Coblence1，，，， 彼得·多尔法勒尔（PeterDorfmüller）3，，，， Elie Fadel4，，，， 奥拉夫·默西尔（Olaf Mercier）4
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慢性血栓栓塞性肺动脉高压和小猪中右心功能的评估

皮埃尔·埃曼纽尔·诺伊（Pierre-Emmanuel Noly）等。 J VIS Exp。 。
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Abstract

一个原始的小猪模型慢性血栓栓塞Pulmonary Hypertension (CTEPH) associated with chronic Right Ventricular (RV) dysfunction is described. Pulmonary Hypertension (PH) was induced in 3-week-old piglets by a progressive obstruction of the pulmonary vascular bed. A ligation of the left Pulmonary Artery (PA) was performed first through a mini-thoracotomy. Second, weekly embolizations of the right lower pulmonary lobe were done under fluoroscopic guidance with n-butyl-2-cyanoacrylate during 5 weeks. Mean Pulmonary Arterial Pressure (mPAP) measured by ritght heart catheterism, increased progressively, as well as Right Atrial pressure and Pulmonary Vascular Resistances (PVR) after 5 weeks compared to sham animals. Right Ventricular (RV) structural and functional remodeling were assessed by transthoracic echocardiography (RV diameters, RV wall thickness, RV systolic function). RV elastance and RV-pulmonary coupling were assessed by Pressure-Volume Loops (PVL) analysis with conductance method. Histologic study of the lung and the right ventricle were also performed. Molecular analyses on RV fresh tissues could be performed through repeated transcutaneous endomyocardial biopsies. Pulmonary microvascular disease in obstructed and unobstructed territories was studied from lung biopsies using molecular analyses and pathology. Furthermore, the reliability and the reproducibility was associated with a range of PH severity in animals. Most aspects of the human CTEPH disease were reproduced in this model, which allows new perspectives for the understanding of the underlying mechanisms (mitochondria, inflammation) and new therapeutic approaches (targeted, cellular or gene therapies) of the overloaded right ventricle but also pulmonary microvascular disease.

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