[Role of inflammation and apoptosis in right ventricular dysfunction induced by injurious mechanical ventilation in

Jun Liu1,2, Dong Han1, Tingting Wang2

  • 1Department of Emergency Intensive Care Unit, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu, China.

Abstract

Insights

High tidal volume mechanical ventilation in rats induced right ventricular dysfunction by causing myocardial inflammation and apoptosis. These findings suggest a link between injurious ventilation and heart damage.

Area of Science:

  • Cardiology and Respiratory Physiology
  • Molecular Biology and Pathology

Background:

  • Mechanical ventilation is crucial for respiratory support but can induce lung injury.
  • High tidal volume (VT) ventilation is associated with ventilator-induced lung injury (VILI).
  • The impact of injurious mechanical ventilation on right ventricular function is not fully understood.

Purpose of the Study:

  • To investigate the role of myocardial inflammation and apoptosis in right ventricular dysfunction (RVD).
  • To determine if injurious mechanical ventilation with high VT in rats induces RVD.
  • To examine the molecular mechanisms, including inflammatory and apoptotic markers, in the right ventricle.

Main Methods:

  • Adult male Sprague-Dawley rats were divided into control, low VT (6 mL/kg), and high VT (20 mL/kg) groups.
  • Hemodynamic parameters (HR, MAP, RVSP, +dp/dt max) and echocardiographic indices (RVEDd/LVEDd, TAPSE, MPI) were measured.
  • Right ventricular tissues were analyzed for histopathology, and mRNA/protein expression of IL-6, TNF-α, caspase-3, Bax, and Bcl-2 were quantified using RT-PCR and Western blotting.

Main Results:

  • High VT ventilation significantly impaired right ventricular systolic pressure and contractility, evidenced by increased RVSP and decreased +dp/dt max.
  • Echocardiography revealed impaired right ventricular dimensions and function in the high VT group, with increased RVEDd/LVEDd and MPI, and decreased TAPSE.
  • Histology showed myocardial inflammation and disorganization in the high VT group. Molecular analysis indicated significantly upregulated IL-6, TNF-α, caspase-3, and Bax, with downregulated Bcl-2 expression in the high VT group compared to controls.

Conclusions:

  • Injurious mechanical ventilation with high tidal volume induces right ventricular dysfunction in rats.
  • Myocardial inflammation and apoptosis, indicated by elevated pro-inflammatory cytokines and altered apoptosis-related protein expression, are involved in this process.
  • These findings highlight the potential cardiotoxic effects of high VT mechanical ventilation.

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