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1 Departamento de Fisiologia, Facultad de Medicina, Universidad de la Republica., Montevideo, Uruguay
2 Facultad de Ingenieria, Ciencias Exactas y Naturales, Universidad Favaloro, Buenos Aires, Argentina
3 Facultad de Ingenieria, Ciencias Exactas y Naturales, Universidad Favaloro, Buenos Aires, Argentina; Departamento de Fisiologia, Facultad de Medicina, Universidad de la Republica., Montevideo, Uruguay
* To whom correspondence should be addressed. E-mail: dbia{at}fmed.edu.uy.
Acute pulmonary hypertension (PH) may arise with or without an increase in vascular smooth muscle (VSM) tone. Our objective was to determine how VSM activation affects both the conduit (CF) and wall buffering (BF) functions of the pulmonary artery (PA) during acute PH states. PA instantaneous flow, pressure and diameter of six sheep were recorded during normal pressure (CTL) and different states of acute PH, 1) passively induced by PA mechanical occlusion (PPH); 2) actively induced by intravenous administration of phenylephrine (APH); and 3) a combination of both (APPH). To evaluate the direct effect of VSM activation, isobaric (PPH versus APH) and isometric (CTL versus APPH) analyses were performed. We calculated the local BF from the elastic (EPD) and viscous (
PD) indexes as
PD/EPD, and the characteristic impedance (ZC) from pressure and flow, to evaluate CF as 1/ZC. We also calculated the absolute and normalized cross-sectional pulsatility (PCS and NPCS, respectively), the dynamic compliance (CDYN), the cross-sectional distensibility (DCS), and the pressure-strain elastic modulus (EP). The isobaric analysis showed increase of CF, BF and
PD (P<0.01) and decrease of EPD (P<0.05) during APH respect to PPH (concomitant with isobaric VSM activation-induced vasoconstriction, P<0.01). The isometric analysis showed increase of EPD and
PD (P<0.01), non significant difference in BF (even in the presence of a significant mean PA pressure rise, from 14±6 to 25±8 mmHg, P<0.01), and decrease in CF (P<0.01) during APPH respect to CTL. Mechanical occlusions (PPH and APPH) reduced BF (P<0.01), and increased EPD (P<0.05) with regard to their previous steady states (CTL and APH). Non significant differences were found in EPD between PPH and APPH. VSM activation (APH and APPH) increased
PD (P<0.01) respect to their previous passive states (CTL and PPH), but no significant differences were found within similar levels of VSM activation. In conclusion, VSM plays a relevant role in main pulmonary artery function during acute pulmonary hypertension, since isobaric vasoconstriction induced by VSM activation improves both BF and CF, mainly due to the increase in
PD concomitant with the arterial compliance. CDYN and DCS were the more pertinent clinical indexes of arterial elasticity. Additionally, the
PD-mediated preservation of the BF could be evaluated by the geometric related indexes (PCS and NPCS), which appear to be qualitative markers of arterial wall viscosity status.
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