Chronic Thromboembolic Pulmonary Hypertension – What Have We Learned From Large Animal Models

Frontiers in Cardiovascular Medicine

Kelly Stam¹  Daphne Merkus²  Yannick J. H. J. Taverne³  Sebastian Clauss⁴ 

[1] Department of Cardiology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands;Department of Cardiology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands;Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany;DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance, Munich, Germany;Department of Cardiothoracic Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands;Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany;Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany;DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance, Munich, Germany;

关键词: CTEPH;    pulmonary hypertension;    pulmonary vasculature;    vascular resistence;    large animal models;    swine models;    arrhythmogenesis;    cardiac remodeling;   

DOI  :  10.3389/fcvm.2021.574360

来源: Frontiers

【 摘 要 】

Chronic thrombo-embolic pulmonary hypertension (CTEPH) develops in a subset of patients after acute pulmonary embolism. In CTEPH, pulmonary vascular resistance, which is initially elevated due to the obstructions in the larger pulmonary arteries, is further increased by pulmonary microvascular remodeling. The increased afterload of the right ventricle (RV) leads to RV dilation and hypertrophy. This RV remodeling predisposes to arrhythmogenesis and RV failure. Yet, mechanisms involved in pulmonary microvascular remodeling, processes underlying the RV structural and functional adaptability in CTEPH as well as determinants of the susceptibility to arrhythmias such as atrial fibrillation in the context of CTEPH remain incompletely understood. Several large animal models with critical clinical features of human CTEPH and subsequent RV remodeling have relatively recently been developed in swine, sheep, and dogs. In this review we will discuss the current knowledge on the processes underlying development and progression of CTEPH, and on how animal models can help enlarge understanding of these processes.

【 授权许可】

CC BY