The primary objective was to create a clinically relevant model of right ventricular hypertension and to study right ventricular myocardial pathophysiology in growing organism. The secondary objective was to analyse the effect of oral enoximone (phosphodiesterase inhibitor) therapy on right ventricular haemodynamic parameters and myocardial changes in biomodel of right ventricular hypertension. The study included a total of 12 piglets of 42 days of age. Under general anaesthesia, pulmonary artery banding (PAB) was performed surgically to constrict the main pulmonary artery to about 70-80 % of its original dimension. The study presented two groups of animals labelled C (control animals with PAB; n = 8) and E (animals with PAB and oral administration of enoximone; n = 4). Direct pressure and echocardiographic measurements were taken during operation (time-1), and again at 40 days after surgery (time-2). The animals were killed, and tissue samples from the heart chambers were collected for quantitative morphological assessment. Statistical analysis was performed on all acquired data. At time-2, the median weight of animals doubled and the median systolic pressure gradient across the PAB increased (46.59 ± 15.87 mmHg vs. 20.29 ± 5.76 mmHg; p < 0.001). Changes in haemodynamic parameters were compatible with right ventricular diastolic dysfunction in all the animals. Apoptosis, tissue proliferation and fibrosis were identified in all the myocardial tissue samples. Right ventricular pressure overload leads to increased apoptosis of cardiac myocytes, proliferation and myocardial fibrosis. Our study did not show evidence of haemodynamic benefit or myocardial protective effect of oral enoximone treatment.

• MeSH
• dysfunkce pravé srdeční komory MeSH
• hemodynamika MeSH
• komorový tlak (srdce) * MeSH
• myokard MeSH
• prasata MeSH
• srdeční komory MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Pulmonary artery banding (PAB) is used as a surgical palliation to reduce excessive pulmonary blood flow caused by congenital heart defects. Due to the lack of microscopic studies dealing with the tissue remodeling caused by contemporary PAB materials, this study aimed to assess histologic changes associated with PAB surgery by analyzing local tissue reaction to the presence of Gore-Tex strips fixed around the pulmonary artery. Gore-Tex strips were used for PAB in a growing porcine model. After 5 weeks, histologic samples with PAB (n = 5) were compared with healthy pulmonary arterial segments distal to the PAB or from a sham-treated animal (n = 1). Stereology was used to quantify the density of the vasa vasorum and the area fraction of elastin, smooth muscle actin, macrophages, and nervi vasorum within the pulmonary arterial wall. The null hypothesis stated that samples did not differ histopathologically from adjacent vascular segments or sham-treated samples. The PAB samples had a greater area fraction of macrophages, a lower amount of nervi vasorum, and a tendency toward decreased smooth muscle content compared with samples that had no PAB strips. There was no destruction of elastic membranes, no medionecrosis, no pronounced inflammatory infiltration or foreign body reaction, and no vasa vasorum deficiency after the PAB. All the histopathologic changes were limited to the banded vascular segment and did not affect distal parts of the pulmonary artery. The study results show the tissue reaction of palliative PAB and suggest that Gore-Tex strips used contemporarily for PAB do not cause severe local histologic damage to the banded segment of the pulmonary arterial wall after 5 weeks in a porcine PAB model.

• MeSH
• arteria pulmonalis patologie   chirurgie   MeSH
• hemodynamika MeSH
• ligace MeSH
• modely nemocí na zvířatech MeSH
• následné studie MeSH
• prasata MeSH
• svaly hladké cévní patologie   MeSH
• vrozené srdeční vady patologie   chirurgie   MeSH
• výkony cévní chirurgie metody   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Léčba srdečního selhání je u dětí založena na omezených důkazech ve srovnání s odpovídají léčbou u dospělých. Přesto existují úspěšné léčebné metody přizpůsobené nebo nově vyvinuté pro dětské pacienty s chronickým nebo akutním srdečním selháním a existují i slibné nové léčebné trendy.

Treatment of paediatric heart failure is based on much less evidence when compared with corresponding treatment in adult population. Nevertheless, successful treatment methods have been adjusted or developed for paediatric patients with chronic and acute heart failure and promising future trends exist.

• MeSH
• akutní nemoc MeSH
• beta blokátory farmakologie   terapeutické užití   MeSH
• chronická nemoc MeSH
• dítě MeSH
• farmakoterapie metody   trendy   MeSH
• klinické zkoušky jako téma MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• pediatrie MeSH
• srdeční selhání etiologie   prevence a kontrola   terapie   MeSH
• transplantace srdce MeSH
• vrozené srdeční vady MeSH
• Check Tag
• dítě MeSH
• lidé MeSH