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Effect of a surgical aortocaval fistula on monocrotaline-induced pulmonary hypertension



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Effect of a surgical aortocaval fistula on monocrotaline induced pulmonary hypertension Toshihiko Nishimura MD PhD John L Faul MD Gerald J Berry MD Peter N Kao MD PhD Ronald G Pearl MD PhD Objective Increased pulmonary blood flow is believed to contribute to the development of pulmonary hypertension We investigated the effect of overcirculation via an aortocaval fistula on the development of monocrotaline induced pulmonary hypertension in rats Monocrotaline was administered 1 wk after the creation of an aortocaval fistula Design Randomized controlled study Setting Research laboratory of an academic institution Subjects Male Sprague Dawley rats Interventions Overcirculation was induced by pneumonectomy and by surgical creation of aortocaval fistula Pulmonary artery hypertension was induced by administration of monocrotaline Measurements and Main Results Aortic blood flow PaO2 and pulmonary arterial pressure were measured 4 wks later A blinded investigator quantified pulmonary arterial neointimal M onocrotaline induced pulmonary hypertension PH has become a reliable and important animal model of pulmonary vascular disease 1 Monocrotaline is a toxic alkaloid extract from the Crotalaria plant Rats characteristically develop pulmonary vascular smooth muscle hypertrophy PH average mean pulmonary arterial pressure mPAP 26 mm Hg and right ventricular hypertrophy average right ventricle left ventricle and septum RV LV S ratio 0 4 4 wks after a single subcutaneous injection of monocrotaline 1 2 In a more recently described model of PH the combination of monocrotaline administration and left pneumonectomy leads to From the Division of Pulmonary and Critical Care Medicine TN JLF PNK and the Departments of Anesthesiology RGP and Pathology GJB Stanford University Medical Center Stanford CA Supported in part by a gift from the Donald E and Delia B Baxter Foundation to Dr Kao Address requests for reprints to Ronald G Pearl PhD Department of Anesthesiology Stanford University



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