Periarteritis in Lung from a Continuous-flow Right Ventricular Assist Device: Role of the Local Renin-Angiotensin System

Overview

Journal Ann Thorac Surg

Publisher Elsevier

Specialties General Surgery
Pulmonary Medicine

Date 2013 Jun 5

PMID 23731607

Citations 2

Authors

Chiyo Ootaki

Michifumi Yamashita

Yoshio Ootaki

Diyar Saeed

Tetsuya Horai

Hideyuki Fumoto

Alex L Massiello

Steven N Emancipator

Leonard A R Golding

Kiyotaka Fukamachi

Affiliations

Soon will be listed here.

Abstract

Background: We previously reported renal arterial periarteritis after implantation of a continuous-flow left ventricular assist device in calves. The purpose of the present study was to investigate whether the same periarteritis changes occur in the intrapulmonary arteries after implantation of a continuous-flow right ventricular assist device (CFRVAD) in calves and to determine the mechanism of those histologic changes.

Methods: Ten calves were implanted with a CFRVAD for 29 ± 7 days, and we compared pulmonary artery samples and hemodynamic data before and after CFRVAD implantation prospectively.

Results: After implantation, the pulsatility index (pulmonary arterial pulse pressure/pulmonary arterial mean pressure) significantly decreased (0.88 ± 0.40 before vs 0.51 ± 0.22 after; p < 0.05), with severe periarteritis of the intrapulmonary arteries in all animals. Periarterial pathology included hyperplasia and inflammatory cell infiltration. The number of inflammatory cells positive for the angiotensin II type 1 receptor was significantly higher after implantation (7.8 ± 6.5 pre-CFRVAD vs 313.2 ± 145.2 at autopsy; p < 0.01). Serum angiotensin-converting enzyme activity significantly decreased after implantation from 100% to 49.7 ± 17.7% at week 1 (p = 0.01). Tissue levels of angiotensin-converting enzyme also demonstrated a significant reduction (0.381 ± 0.232 before implantation vs 0.123 ± 0.096 at autopsy; p = 0.043).

Conclusions: Periarteritis occurred in the intrapulmonary arteries of calves after CFRVAD implantation. The local renin-angiotensin system (not the angiotensin-converting enzyme pathway) plays an important role in such changes.

Citing Articles

The role of renin-angiotensin system in patients with left ventricular assist devices.

Briasoulis A, Duque E, Mouselimis D, Tsarouchas A, Bakogiannis C, Alvarez P J Renin Angiotensin Aldosterone Syst. 2020; 21(4):1470320320966445.

PMID: 33084480 PMC: 7871286. DOI: 10.1177/1470320320966445.

Letter to the Editor regarding the article "Left ventricular assist devices: a kidney's perspective".

Cooper T Heart Fail Rev. 2015; 20(6):751-2.

PMID: 26387095 DOI: 10.1007/s10741-015-9504-9.

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