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1 Division of Pulmonary Biology; Department of Pediatrics, Cincinnati Children's Hospital Medical Center; University of Cincinnati, Cincinnati, Ohio, USA
2 Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA
* To whom correspondence should be addressed. E-mail: tim.lecras{at}CCHMC.ORG.
Studies in animal models have shown that following lobectomy, there is compensatory growth in the remaining lung. The vascular growth response following right lobectomy (R-LBX) is poorly understood. To test the hypothesis that arterial growth and remodeling occurs in response to LBX, in proportion to the amount of right lung tissue removed, two (24% of lung mass; R-LBX2 group) or three right lobes (52% of lung mass; R-LBX3 group) were removed via thoracotomy from adult rats. Sham control animals underwent thoracotomy only. Arteriograms were generated three weeks after surgery. The area of the left lung arteriogram, arterial branching, length of arterial branches, arterial density, and arterial to alveolar ratios were measured. To determine if R-LBX causes vascular remodeling and pulmonary hypertension, muscularization of arterioles and right ventricular hypertrophy were assessed. Lung weight and volume indices were greater in R-LBX3. Arterial area of the left lung increased 26% in R-LBX2 and 46% in R-LBX3. The length of large arteries increased in R-LBX3, and to a lesser extent in R-LBX2. The ratio of distal pulmonary arteries to alveoli was similar after R-LBX2 compared to sham, but was 30% lower in R-LBX3. Muscularization of arterioles increased after R-LBX3, but not in R-LBX2. Right ventricular hypertrophy increased 50-70% in R-LBX3, but not in R-LBX2. While removal of three right lung lobes induced arterial growth in the left lungs of adult rats, which was proportionate to the number of lobes removed, the ratio of distal pulmonary arteries to alveoli was not normal, and vascular remodeling and pulmonary hypertension developed.
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