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The pulmonary vasculature in a neonatal porcine model with increased pulmonary blood flow and pressure

Published online by Cambridge University Press:  15 August 2006

Elisabeth V. Stenbøg
Affiliation:
Dept of Cardiothoracic Surgery, Aarhus University Hospital, Denmark
Daniel A. Steinbrüchel
Affiliation:
Dept of Cardiothoracic Surgery, Aarhus University Hospital, Denmark
Anne Bloch Thomsen
Affiliation:
Dept of Cardiothoracic Surgery, Aarhus University Hospital, Denmark
Ulrik Baandrup
Affiliation:
The Institute of Pathology (KH), Aarhus University Hospital, Denmark
Lene Heickendorff
Affiliation:
Dept of Clinical Biochemistry (AAS), Aarhus University Hospital, Denmark
Jørgen Ingerslev
Affiliation:
Center of Haemophilia and Thrombosis, Aarhus University Hospital, Denmark
Niels Trolle Andersen
Affiliation:
Dept of Biostatistics, University of Aarhus, Denmark
Kristian Emmertsen
Affiliation:
Dept of Cardiology (SKS), Aarhus University Hospital, Denmark

Abstract

Introduction: Hypertension and hyperperfusion of the pulmonary vascular bed in the setting of congenital cardiac malformations may lead to progressive pulmonary vascular disease. To improve the understanding of the basic mechanisms of this disease, there is a need for clinically relevant animal models which reflect the disease process. Material and Results: We randomly allocated 45 newborn pigs, at the age of 48 hrs, to groups in which there was either construction of a 3 mm central aorto-pulmonary shunt, undertaken in 9, or ligation of the left pulmonary artery, achieved in 13. Controls included sham operations in 13, or no operations in 10 pigs. Follow-up was continued for three months. The interventions were compatible with survival in most pigs. The shunts resulted in an acute 85% increase in systolic pulmonary arterial pressure, and a more than twofold increase in pulmonary blood flow. By three months of age, nearly all shunts had closed spontaneously, and haemodynamics were normal. Ligation of the left pulmonary artery resulted in a normal total pulmonary blood flow, despite only the right lung being perfused, and a 33% increase in systolic pulmonary arterial pressure. These haemodynamic changes were maintained throughout the period of study. In both groups, histomorphometry revealed markedly increased muscularity of the intra-acinar pulmonary arteries. Circulating levels of endothelin were normal in the shunted animals, and elevated in those with ligation of the left pulmonary artery. Conclusion: In neonatal porcine models of pulmonary vascular disease, created by construction of 3 mm central aorto-pulmonary shunts and ligation of one pulmonary artery, we observed histopathological changes of the pulmonary vasculature similar to early hypertensive pulmonary vascular disease in humans. Elevated circulating levels of endothelin were associated with abnormal haemodynamics rather than abnormal pathology. These findings could be valuable for future studies on the pathogenesis of hypertensive pulmonary vascular disease associated with congenital cardiac malformations.

Type
Original Article
Copyright
2001 Cambridge University Press

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