Distinct loading conditions reveal various patterns of right ventricular adaptation

Am J Physiol Heart Circ Physiol. 2013 Aug 1;305(3):H354-64. doi: 10.1152/ajpheart.00180.2013. Epub 2013 May 31.


Right ventricular (RV) failure due to chronically abnormal loading is a main determinant of outcome in pulmonary hypertension (PH) and congenital heart disease. However, distinct types of RV loading have been associated with different outcomes. To determine whether the adaptive RV response depends on loading type, we compared hemodynamics, exercise, and hypertrophy in models of pressure overload due to pulmonary artery banding (PAB), pressure overload due to PH, combined pressure and volume overload, and isolated volume load. Ninety-four rats were subjected to either PAB, monocrotaline-induced PH (PH), aortocaval shunt (shunt), or combined monocrotaline and aortocaval shunt (PH + shunt). We performed pressure-volume analysis and voluntary exercise measurements at 4 wk. We compared PAB to PH (part I) and PH + shunt to either isolated PH or shunt (part II). In part I, enhanced contractility (end-systolic elastance and preload recruitable stroke work) was present in PH and PAB, but strongest in PAB. Frank-Starling mechanism was active in both PAB and PH. In PAB this was accompanied by diastolic dysfunction (increased end-diastolic elastance, relaxation constant), clinical signs of RV failure, and reduced exercise. These distinct responses were not attributable to differences in hypertrophy. In part II, in PH + shunt the contractility response was blunted compared with PH, which caused pseudonormalization of parameters. Additional volume overload strongly enhanced hypertrophy in PH. We conclude that different types of loading result in distinct patterns of RV adaptation. This is of importance for the approach to patients with chronically increased RV load and for experimental studies in various types of RV failure.

Keywords: contractility; monocrotaline; pressure-volume analysis; pulmonary hypertension; right ventricular failure.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological
  • Animals
  • Arteriovenous Shunt, Surgical
  • Constriction
  • Disease Models, Animal
  • Familial Primary Pulmonary Hypertension
  • Gene Expression Regulation
  • Heart Failure / diagnosis
  • Heart Failure / etiology
  • Heart Failure / genetics
  • Heart Failure / physiopathology*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology*
  • Hemodynamics
  • Hypertension, Pulmonary / chemically induced
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / genetics
  • Hypertension, Pulmonary / physiopathology*
  • Hypertrophy, Right Ventricular / etiology
  • Hypertrophy, Right Ventricular / physiopathology
  • Male
  • Models, Cardiovascular
  • Monocrotaline
  • Myocardial Contraction
  • Physical Exertion
  • Pulmonary Artery / physiopathology
  • Pulmonary Artery / surgery
  • Rats
  • Rats, Wistar
  • Stroke Volume
  • Time Factors
  • Ultrasonography
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / etiology
  • Ventricular Dysfunction, Right / genetics
  • Ventricular Dysfunction, Right / physiopathology*
  • Ventricular Function, Right*
  • Ventricular Pressure


  • Monocrotaline