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Impact of Acute Pulmonary Embolization on Arterial Stiffening and Right Ventricular Function in Dogs

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Abstract

Pulmonary hypertension (PH) can impact right ventricular (RV) function and alter pulmonary artery (PA) stiffness. The response of the RV to an acute increase in pulmonary pressure is unclear. In addition, the relation between total pulmonary arterial compliance and local PA stiffness has not been investigated. We used a combination of right heart catheterization (RHC) and magnetic resonance imaging (MRI) to assess PA stiffening and RV function in dogs before and after acute embolization. We hypothesized that in moderate, acute PH the RV is able to compensate for increased afterload, maintaining adequate coupling. Also, we hypothesized that in the absence of PA remodeling the relative area change in the proximal PA (RAC, a noninvasive index of local area strain) correlates with the total arterial compliance (stroke volume-to-pulse pressure ratio). Our results indicate that, after embolization, RV function is able to accommodate the demand for increased stroke work without uncoupling, albeit at the expense of a reduction of efficiency. In this acute model, RAC showed excellent correlation with total arterial compliance. We used this correlation to assess PA pulse pressure (PP) from noninvasive MRI measurements of stroke volume and RAC. We demonstrated that in acute pulmonary embolism MRI estimates of PP are remarkably close to measurements from RHC. These results, if confirmed in chronic PH and clinically, suggest that monitoring of PH progression by noninvasive methods may be possible.

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Acknowledgments

The authors gratefully acknowledge funding support from NIH 1R01HL105598 (NCC) and Department of Radiology (CJF).

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Authors and Affiliations

  1. Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Drive, Madison, WI, 53706-1609, USA

    Alessandro Bellofiore & Matthieu Besse

  2. Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-3252, USA

    Alejandro Roldán-Alzate, Daniel W. Consigny & Christopher J. Francois

  3. School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI, 53706-1102, USA

    Heidi B. Kellihan

  4. Department of Biomedical Engineering, University of Wisconsin-Madison, 2146 Engineering Centers Building, 1550 Engineering Drive, Madison, WI, 53706-1609, USA

    Naomi C. Chesler

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  1. Alessandro Bellofiore
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Correspondence to Naomi C. Chesler.

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Associate Editor Ender A. Finol oversaw the review of this article.

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Bellofiore, A., Roldán-Alzate, A., Besse, M. et al. Impact of Acute Pulmonary Embolization on Arterial Stiffening and Right Ventricular Function in Dogs. Ann Biomed Eng 41, 195–204 (2013). https://doi.org/10.1007/s10439-012-0635-z

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  • DOI: https://doi.org/10.1007/s10439-012-0635-z

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