This research is supported by the Postgraduate Education and Teaching Reform Project of Peking Union Medical College (10023-2016-002-03), the Fuwai Hospital Youth Fund (2018-F09), and the Director Fund of Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials (2018-PT2-ZR05).

The animal protocol was reviewed and approved by the Institutional Animal Care and Use Committee at Fuwai Hospital, Chinese Academy of Medical Science, Peking Union Medical College (NO.0000287). The experimental animals were housed and fed according to the guidelines of animal welfare in China.
NOTE: Eight- to 12-week-old male C57BL mice were housed in an environment with a 12 h dark/ 12 h light cycle. The PAH mice were housed for 4 weeks under an oxygen concentration of 10%, maintained by an ...

<ol>
	<li>Humbert, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Advances+in+therapeutic+interventions+for+patients+with+pulmonary+arterial+hypertension.">Advances in therapeutic interventions for patients with pulmonary arterial hypertension.</a> Circulation. 130 (24), 2189-2208 (2014).</li><li>Chatterjee, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Swan-Ganz+catheters:+past,+present,+and+future:+a+viewpoint.">The Swan-Ganz catheters: past, present, and future: a viewpoint.</a> Circulation. 119 (1), 147-152 (2009).</li><li>Adamson, P. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CHAMPION+trial+rationale+and+design:+the+long-term+safety+and+clinical+efficacy+of+a+wireless+pulmonary+artery+pressure+monitoring+system.">CHAMPION trial rationale and design: the long-term safety and clinical efficacy of a wireless pulmonary artery pressure monitoring system.</a> Journal of Cardiac Failure. 17 (1), 3-10 (2011).</li><li>Abraham, W. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Wireless+pulmonary+artery+haemodynamic+monitoring+in+chronic+heart+failure:+a+randomised+controlled+trial.">Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial.</a> The Lancet. 377 (9766), 658-666 (2011).</li><li>Adamson, P. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Wireless+pulmonary+artery+pressure+monitoring+guides+management+to+reduce+decompensation+in+heart+failure+with+preserved+ejection+fraction.">Wireless pulmonary artery pressure monitoring guides management to reduce decompensation in heart failure with preserved ejection fraction.</a> Circulation: Heart Failure. 7 (6), 935-944 (2014).</li><li>Shatat, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endothelial+Kruppel-like+Factor+4+modulates+pulmonary+arterial+hypertension.">Endothelial Kruppel-like Factor 4 modulates pulmonary arterial hypertension.</a> American Journal of Respiratory Cell and Molecular Biology. 50 (3), 647-653 (2014).</li><li>. SPR-1000 Mouse Pressure Catheter Available from: <a target="_blank" href="https://millar.com/products/research/pressure/single-pressure-no-lumen/spr-1000">https://millar.com/products/research/pressure/single-pressure-no-lumen/spr-1000</a> (2019)</li><li>Tabima, D. M., Hacker, T. A., Chesler, N. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measuring+right+ventricular+function+in+the+normal+and+hypertensive+mouse+hearts+using+admittance-derived+pressure-volume+loops.">Measuring right ventricular function in the normal and hypertensive mouse hearts using admittance-derived pressure-volume loops.</a> American Journal of Physiology Heart and Circulatory Physiology. 299 (6), 2069-2075 (2010).</li><li>Skuli, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endothelial+deletion+of+hypoxia-inducible+factor-2alpha+(HIF-2alpha)+alters+vascular+function+and+tumor+angiogenesis.">Endothelial deletion of hypoxia-inducible factor-2alpha (HIF-2alpha) alters vascular function and tumor angiogenesis.</a> Blood. 114 (2), 469-477 (2009).</li><li>. LabChart Available from: <a target="_blank" href="https://www.adinstruments.com/products/labchart?creative=290739105773_keyword=labchart_matchtype=e_network=g_device=c_gclid=CjwKCAjwxrzoBRBBEiwAbtX1n42I2S06KmccVncUHkmExU8KKOXXREyzx8bvTrxYMSze-ooE0atcbRoCliwQAvD_BwE">https://www.adinstruments.com/products/labchart?creative=290739105773_keyword=labchart_matchtype=e_network=g_device=c_gclid=CjwKCAjwxrzoBRBBEiwAbtX1n42I2S06KmccVncUHkmExU8KKOXXREyzx8bvTrxYMSze-ooE0atcbRoCliwQAvD_BwE</a> (2019)</li><li>Marius, M. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Definitions+and+diagnosis+of+pulmonary+hypertension.">Definitions and diagnosis of pulmonary hypertension.</a> Journal of the American College of Cardiology. 62 (25), 42-50 (2013).</li><li>Ciuclan, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+murine+model+of+severe+pulmonary+arterial+hypertension.">A novel murine model of severe pulmonary arterial hypertension.</a> American Journal of Respiratory and Critical Care Medicine. 184 (10), 1171-1182 (2011).</li><li>Brown, R. H., Walters, D. M., Greenberg, R. S., Mitzner, W. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+method+of+endotracheal+intubation+and+pulmonary+functional+assessment+for+repeated+studies+in+mice.">A method of endotracheal intubation and pulmonary functional assessment for repeated studies in mice.</a> Journal of Applied Physiology. 87 (6), 2362-2365 (1999).</li><li>Chen, W. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Right+ventricular+systolic+pressure+measurements+in+combination+with+harvest+of+lung+and+immune+tissue+samples+in+mice.">Right ventricular systolic pressure measurements in combination with harvest of lung and immune tissue samples in mice.</a> Journal of Visualized Experiments. (71), 50023 (2013).</li><li>Ma, Z., Mao, L., Rajagopal, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hemodynamic+characterization+of+rodent+models+of+pulmonary+arterial+hypertension.">Hemodynamic characterization of rodent models of pulmonary arterial hypertension.</a> Journal of Visualized Experiments. (110), 53335 (2016).</li><li>Chen, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Berberine+attenuates+hypoxia-induced+pulmonary+arterial+hypertension+via+bone+morphogenetic+protein+and+transforming+growth+factor-&#946;+signaling.">Berberine attenuates hypoxia-induced pulmonary arterial hypertension via bone morphogenetic protein and transforming growth factor-&#946; signaling.</a> Journal of Cellular Physiology. , (2019).</li><li>Bueno-Beti, C., Hadri, L., Hajjar, R. J., Sassi, Y., Ishikawa, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Sugen+5416/Hypoxia+mouse+model+of+pulmonary+arterial+hypertension.">The Sugen 5416/Hypoxia mouse model of pulmonary arterial hypertension.</a> Experimental Models of Cardiovascular Diseases. Methods in Molecular Biology. vol 1816. , (2018).</li></ol>

Tracheal intubation is the first important step for open-chest surgeries. The classic method of tracheal intubation for small animals, such as rats or mice, involves making a T-shaped incision on the trachea and directly inserting Y-type tracheal tubing into the trachea. In practice, we find that this method is not easy during operation. The Y-type tracheal tubing is too large for small animals and forms an angle with the trachea. Thus, it is difficult to fix the tubing in place. Additionally, once the intubation tubing ...

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder with elevation in pulmonary artery pressure (PAP) and right ventricular pressure (RVP) that is caused by cellular proliferation and fibrosis of small pulmonary arteries1. Pulmonary artery catheters, also called Swan-Ganz catheters2, are commonly used in the clinical monitoring of RVP and PAP. Furthermore, a wireless PAP monitoring system has been used clinically3,4,5. To mimic the disease for study in mice, a hypoxic environment is used to simulate human clinical manifestations of PAH6. In the evaluation of PAP in animals, large animals are relatively easy to monitor through pulmonary artery catheters using the same technique as for human subjects, but small animals such as rats and mice are difficult to assess because of their small body size. Hemodynamic measurement of the right ventricular system in mice is possible with an ultrasmall size 1 Fr catheter7. A method for measuring RVP and PAP in mice has been reported in the literature8,9, but the methodology lacks a detailed description. RVP and PAP are more challenging to measure than left ventricular pressure because of the anatomical differences between the left and right heart systems.
To get both PAP and RVP parameters in the same mouse, we describe an open-chest surgery-based approach for right heart hemodynamic measurements, its validation with healthy and PAH mice, and how to avoid generating artificial data during the complicated open-chest surgery. Although this technique is best performed by a well-trained surgeon, it has the advantage of being able to assess PAP and RVP in the same mouse.

<table border="0" cellpadding="0" cellspacing="0" style="width:764px;" width="764">
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		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">2,2,2-Tribromoethanol</td>
			<td style="width:192px;">Sigma-Aldrich</td>
			<td style="width:157px;">T48402-5G</td>
			<td style="width:183px;">For anesthesia</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Animal temperature controller</td>
			<td style="width:192px;">Physitemp Instruments, Inc.</td>
			<td style="width:157px;">TCAT-2LV</td>
			<td style="width:183px;">For temperature control</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Dissection forceps</td>
			<td style="width:192px;">Fine Science Tools, Inc.</td>
			<td style="width:157px;">11274-20</td>
			<td style="width:183px;">For surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Gemini Cautery System</td>
			<td style="width:192px;">Gemini</td>
			<td style="width:157px;">GEM 5917</td>
			<td style="width:183px;">For surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Intravenous catheter (22G)</td>
			<td style="width:192px;">BD angiocath</td>
			<td style="width:157px;">381123</td>
			<td style="width:183px;">For intubation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">LabChart 7.3</td>
			<td style="width:192px;">ADInstruments</td>
			<td style="width:157px;"></td>
			<td style="width:183px;">For data analysis</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Light illumination system</td>
			<td style="width:192px;">Olympus</td>
			<td style="width:157px;"></td>
			<td style="width:183px;">For surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Mikro-Tip catheter</td>
			<td style="width:192px;">Millar Instruments, Houston, TX</td>
			<td style="width:157px;">SPR-1000</td>
			<td style="width:183px;">For pressure measurement</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Millar Pressure-Volume Systems</td>
			<td style="width:192px;">Millar Instruments, Houston, TX</td>
			<td style="width:157px;">MVPS-300</td>
			<td style="width:183px;">For pressure measurement</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">O2 Controller and Hypoxia chamber</td>
			<td style="width:192px;">Biospherix</td>
			<td style="width:157px;">ProOx 110</td>
			<td style="width:183px;">For chronic hypoxia</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">PowerLab Data Acquisition System</td>
			<td style="width:192px;">ADInstruments</td>
			<td style="width:157px;">PowerLab 16/30</td>
			<td style="width:183px;">For data recording</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Scissors</td>
			<td style="width:192px;">Fine Science Tools, Inc.</td>
			<td style="width:157px;">14084-08</td>
			<td style="width:183px;">For surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Small animal ventilator</td>
			<td style="width:192px;">Harvard Apparatus</td>
			<td style="width:157px;">Mini-Vent 845</td>
			<td style="width:183px;">For surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Stereomicroscope</td>
			<td style="width:192px;">Olympus</td>
			<td style="width:157px;">SZ61</td>
			<td style="width:183px;">For surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Surgery tape</td>
			<td style="width:192px;">3M</td>
			<td style="width:157px;"></td>
			<td style="width:183px;">For surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:232px;">Terg-a-zyme enzyme</td>
			<td style="width:192px;">Sigma-Aldrich</td>
			<td style="width:157px;">Z273287-1EA</td>
			<td style="width:183px;">For catheter cleaning</td>
		</tr>
	</tbody>
</table>

invasive hemodynamic assessment for the right ventricular system and hypoxia-induced pulmonary arterial hypertension in mice

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. However, the evaluation of right ventricular pressure (RVP) and pulmonary artery pressure (PAP) remains technically challenging in mice. RVP and PAP are more difficult to measure than left ventricular pressure because of the anatomical differences between the left and right heart systems. In this paper, we describe a stable right heart hemodynamic measurement method and its validation using healthy and PAH mice. This method is based on open-chest surgery and mechanical ventilation support. It is a complicated procedure compared to closed chest procedures. While a well-trained surgeon is required for this surgery, the advantage of this procedure is that it can generate both RVP and PAP parameters at the same time, so it is a preferable procedure for the evaluation of PAH models.

The pressure transducer catheter was inserted into the right ventricle (Figure 3A) through a tunnel expanded by a 25 G needle, and a typical RVP waveform (Figure 3C) was obtained. The catheter was continually adjusted and slowly advanced and kept in the same axis as the pulmonary artery while passing through the pulmonary valve (Figure 3B). When the pressure sensor was successfully ...

Watch this Scientific Journal Video about Invasive Hemodynamic Assessment for the Right Ventricular System and Hypoxia-Induced Pulmonary Arterial Hypertension in Mice at JoVE.com

Invasive Hemodynamic Assessment for the Right Ventricular System and Hypoxia-Induced Pulmonary Arterial Hypertension in Mice

Here, we present a protocol to perform an invasive hemodynamic assessment of the right ventricle and pulmonary artery in mice using an open-chest surgery approach.

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. ...

This protocol is an open chest surgery based hemodynamic assessment and it is useful for the right ventricular and pulmonary artery pressure evaluation in small animals such as mice. The advantage of this procedure is that it can generate both VP and PAP parameters at the same time. So it is preferable for evaluations of PAH models.Begin by setting up the equipment for surgery. Soak the pressure transducer catheter in 0.9%saline at room temperature for at least 30 minutes before the hemodynamic experiment. Then, connect the catheter to a pressure volume system.Calibrate the pressure transducer by turning the calibration knob to zero and 25 millimeters of mercury to send a verification pressure signal to the data acquisition software, then configure the calibration setting. Turn the knob to transducer, and adjust the balance valve to zero baseline. Set up a standard stereo microscope, temperature controlled small animal surgical table, and a light illumination system for microsurgery.Once the mouse is properly anesthetized, remove the chest and neck fur using a shaver and hair removal lotion. Secure the mouse in the supine position on the temperature controlled surgical table. After ensuring that the anesthesia is in effect, make a midline incision on the neck skin.Dissect the skeletal muscle using curved forceps and expose the trachea. Perform intubation through the mouth with a 22 gauge intravenous sheath catheter, confirming that the tubing is in the trachea with forceps. Connect the tubing to a small animal ventilator and secure it for ventilation using tape.Then, make a midline incision on the chest skin and carefully dissect the chest muscle using a cautery tool. Cut the sternum using scissors across the middle, and expose the thoracic cavity. Make sure to prevent any bleeding using the cautery tool.Expose the right ventricle with retractors, then insert the saline soaked pressure transducer catheter through a small tunnel created with a 25 gauge needle into the right ventricle to measure right ventricular pressure, or RVP. Hold the catheter cable and cross the pulmonary valve in a coaxial manner with the pulmonary artery. Observe the pressure waveform, and obtain a stable pulmonary artery pressure or PAP signal.Next, record the hemodynamic data using the data acquisition software. Carefully remove the catheter from the right heart system and place it into a one milliliter syringe containing 1%digestive enzyme solution. This protocol was successfully used to obtain RVP and PAP waveforms in mice by inserting a pressure transducer catheter into the right ventricle and the pulmonary artery.In order to avoid generating artificial data, segments with noise were excluded from the data analysis and corrections were made if the zero level of the catheter had drifted. RVP and PAP were measured in mice with induced chronic hypoxia, and the results were compared to those obtained from a control group. Systolic PAP, diastolic PAP, mean PAP, and right ventricular systolic pressure were all significantly increased in the chronic hypoxia group.The most important thing to remember is to insert the pressure transducer catheter into the right ventricle carefully, making sure to avoid damage to the catheter and confirm the smooth RVP waveform appears on the screen.

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8.9K visualizações.  Chinese Academy of Medical Sciences and Peking Union Medical College. Este protocolo é uma avaliação hemodinâmica baseada em cirurgia torácica aberta e é útil para a avaliação de pressão ventricular e pulmonar direita em pequenos animais, como camundongos. A vantagem deste procedimento é que ele pode gerar parâmetros VP e PAP ao mesmo tempo. Por isso, é preferível para avaliações de modelos PAH.Comece montando o equipamento para a cirurgia. Mergulhe o cateter transdutor de pressão em 0,9% salino à temperatura ambiente por pelo menos 30 ...