The authors acknowledge Department of Biotechnology, Government of India for financial support of this project. Ajith Kumar G S was supported with senior research fellowship from Council of Scientific and Industrial Research, Government of India and Binil Raj with senior research fellowship from Indian Council of Medical Research, Government of India.

Animal experiments were performed after obtaining approval from the Institutional Animal Ethics Committee. Wistar rats were housed under a 12 hr&#160;dark to light cycle, constant room temperature (24 &#177; 2 &#176;C) with food and water ad libitum (as per the CPCSEA guidelines).
1) Pre-operative Care and Anesthesia
<ol>
	<li>Keep rat (approximately 200 g&#160;body weight) under antibiotic umbrella 24 hr&#160;before surgery by administering amoxicillin orally (dose: 500 mg/L of water).</li>
	<li>Sterilize all surgical tools (such as scissors, forceps, clip applicator, suture needles, and needle holder) by autoclaving at 121 &#176;C for 15 min.</li>
	<li>Use a heating pad to maintain the animal body temperature around 37 &#176;C to avoid a rapid decrease in heart rate.</li>
	<li>Take care to avoid dehydration of the animal before and during surgery.</li>
	<li>Anesthetize the rat in an induction chamber with 3% isoflurane mixed with 0.5-1.0 L/min 100% oxygen; maintain anesthesia with 1.5% isoflurane.</li>
	<li>Check the pedal reflex to confirm successful anesthesia.</li>
</ol>
2) Preparation of the Surgical Site
<ol>
	<li>Keep the rat on top of a temperature controlled heating pad in the supine position.</li>
	<li>Position a rubber band over the rat&#8217;s front teeth to keep the animal in position while maintaining anesthesia with a nose cone.</li>
	<li>Remove fur from the neckline and left chest region of the rat (preferably using an electric shaver).</li>
	<li>Disinfect surgical site with povidone-iodine solution and then with 70% ethyl alcohol.</li>
	<li>Use a sterile drape to expose only the surgical site during the operative procedure. 
	Note: As an additional option for the animal care, 0.25% Bupivicaine ID (2.5 mg/kg) can be incorporated prior to incising at each incision site for local anesthesia/analgesia.</li>
</ol>
3) Tracheal Intubation in Rat
<ol>
	<li>Make a small incision on the skin parallel to the trachea using a sterile surgical blade and carefully separate the underlying tissue in order to expose the trachea.</li>
	<li>Apply a tie of 4-0 silk suture thread underneath the trachea and gently raise the tie upward.</li>
	<li>Make a half way incision between two cartilage rings and insert the tracheal cannula into the trachea of the rat.</li>
	<li>Connect the tracheal canula to a rodent ventilator for maintaining a respiratory rate of 50 breaths/min, tidal volume of 1.70 ml and inspiration time of 0.60 sec&#160;(for rat with 200 g&#160;body weight).</li>
</ol>
4) Constriction of Ascending Aorta
<ol>
	<li>After sensing the position of the ribs with fingers, make a skin incision of about 2 cm on the left chest wall between the second and third ribs.</li>
	<li>Separate the intercostal muscles layer by layer and make an incision about 1.5 cm long between the second and third ribs. (Care should be taken to avoid any injury to the lungs while making incision between the ribs)</li>
	<li>Retract the ribs and locate the ascending portion of the aorta.</li>
	<li>Place a small sized titanium clip around the ascending aorta with the help of an applicator whereby constricting the aorta to 50&#8211;60% of the original diameter.</li>
	<li>Following the aortic constriction, approximate the second and third ribs with 3.0 prolene in an interrupted suture pattern. Simultaneously, pause the ventilator for about 2-4 sec&#160;in order to re-inflate the lungs.</li>
	<li>Appose the muscle layers with 3.0 prolene sutures and skin with 4.0 silk sutures in an interrupted suture pattern. Synthetic non absorbable sutures can be used instead of silk for suturing the skin.</li>
	<li>Remove tracheal cannula from the rat once spontaneous breathing is re-established.</li>
	<li>Close the tracheal opening with 3.0 prolene sutures and the skin layer with 4.0 silk sutures.</li>
	<li>Allow the animal to recover on the heating pad by gradually lowering the anesthesia and ventilator assisted respiration.</li>
	<li>In age-matched sham control animals, perform tracheotomy and thoracotomy without constriction of ascending aorta.</li>
</ol>
5) Post-operative Care
<ol>
	<li>Disinfect surgical area with povidone-iodine solution.</li>
	<li>As post-operative analgesia, inject tramadol intra-peritoneally (10 mg/kg body weight/day) for 1&#160;week.</li>
	<li>Inject sterile normal saline intra-peritoneally if signs of dehydration appear after surgery (approximately 1 ml).</li>
	<li>Administer amoxycillin orally, mixed with drinking water, for seven days (dose: 500 mg/L of water).</li>
	<li>Remove any remaining silk sutures from the skin post 10 days of surgery under inhalation anesthesia.</li>
</ol>
6) Confirmation of Successful Constriction of Ascending Aorta
<ol>
	<li>Perform a trans-thoracic two dimensional Doppler- echocardiography to determine the intensity of the pressure overload produced by the constriction of ascending aorta.</li>
	<li>Anesthetize the rats one week post-surgery as described earlier (step 1.5)</li>
	<li>Place the ultrasound transducer at the supra sternal position to record the pressure gradient across the constricted portion of ascending aorta. 
	Note: Rats with a pressure gradient of about 60 mm of Hg at the aortic constricted site will develop severe cardiac hypertrophy by about 8-10 weeks post surgery.</li>
</ol>

<ol>
	<li>Patten, R. D., Hall-Porter, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small+animal+models+of+heart+failure:+development+of+novel+therapies,+past+and+present.">Small animal models of heart failure: development of novel therapies, past and present.</a> Circ Heart Fail. 2, 138-144 (2009).</li><li>Weinberg, E. O., 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=Angiotensin-converting+enzyme+inhibition+prolongs+survival+and+modifies+the+transition+to+heart+failure+in+rats+with+pressure+overload+hypertrophy+due+to+ascending+aortic+stenosis.">Angiotensin-converting enzyme inhibition prolongs survival and modifies the transition to heart failure in rats with pressure overload hypertrophy due to ascending aortic stenosis.</a> Circulation. 90, 1410-1422 (1994).</li><li>Schunkert, 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=Increased+rat+cardiac+angiotensin+converting+enzyme+activity+and+mRNA+expression+in+pressure+overload+left+ventricular+hypertrophy.+Effects+on+coronary+resistance,+contractility,+and+relaxation.">Increased rat cardiac angiotensin converting enzyme activity and mRNA expression in pressure overload left ventricular hypertrophy. Effects on coronary resistance, contractility, and relaxation.</a> J Clin Invest. 86, 1913-1920 (1990).</li><li>Hasenfuss, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+of+human+cardiovascular+disease,+heart+failure+and+hypertrophy.">Animal models of human cardiovascular disease, heart failure and hypertrophy.</a> Cardiovasc Res. 39, 60-76 (1998).</li><li>Litwin, S. E., 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=Serial+echocardiographic-Doppler+assessment+of+left+ventricular+geometry+and+function+in+rats+with+pressure-overload+hypertrophy.+Chronic+angiotensin-converting+enzyme+inhibition+attenuates+the+transition+to+heart+failure.">Serial echocardiographic-Doppler assessment of left ventricular geometry and function in rats with pressure-overload hypertrophy. Chronic angiotensin-converting enzyme inhibition attenuates the transition to heart failure.</a> Circulation. 91, 2642-2654 (1995).</li><li>Miyamoto, M. I., 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=Adenoviral+gene+transfer+of+SERCA2a+improves+left-ventricular+function+in+aortic-banded+rats+in+transition+to+heart+failure.">Adenoviral gene transfer of SERCA2a improves left-ventricular function in aortic-banded rats in transition to heart failure.</a> Proc Natl Acad Sci U S A. 97, 793-798 (2000).</li><li>Kagaya, Y., Hajjar, R. J., Gwathmey, J. K., Barry, W. H., Lorell, B. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+angiotensin-converting+enzyme+inhibition+with+fosinopril+improves+depressed+responsiveness+to+Ca2++in+myocytes+from+aortic-banded+rats.">Long-term angiotensin-converting enzyme inhibition with fosinopril improves depressed responsiveness to Ca2+ in myocytes from aortic-banded rats.</a> Circulation. 94, 2915-2922 (1996).</li><li>Del Monte, F., Butler, K., Boecker, W., Gwathmey, J. K., Hajjar, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+technique+of+aortic+banding+followed+by+gene+transfer+during+hypertrophy+and+heart+failure.">Novel technique of aortic banding followed by gene transfer during hypertrophy and heart failure.</a> Physiol Genomics. 9, 49-56 (2002).</li><li>Turcani, M., Rupp, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heart+failure+development+in+rats+with+ascending+aortic+constriction+and+angiotensin-converting+enzyme+inhibition.">Heart failure development in rats with ascending aortic constriction and angiotensin-converting enzyme inhibition.</a> Br J Pharmacol. 130, 1671-1677 (2000).</li><li>Kerem, 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=Lung+endothelial+dysfunction+in+congestive+heart+failure:+role+of+impaired+Ca2++signaling+and+cytoskeletal+reorganization.">Lung endothelial dysfunction in congestive heart failure: role of impaired Ca2+ signaling and cytoskeletal reorganization.</a> Circ Res. 106, 1103-1116 (2010).</li><li>Almeida, A. C., van Oort, R. J., Wehrens, X. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transverse+aortic+constriction+in+mice.">Transverse aortic constriction in mice.</a> J Vis Exp. (38), (2010).</li></ol>

The authors have nothing to disclose.

There are several surgical models for the induction of pressure overload as well as cardiac hypertrophy and heart failure. In small animals, Lorell and colleagues developed the model we have described here and they reported the occurrence of compensated cardiac hypertrophy 8 weeks post aortic banding5. Cardiac changes gradually progress to a decompensated state and then result in heart failure. The main advantage of this model is the gradual onset of increase in left ventricular pressure and thus similar to cl...

Small animal models are the most preferred tools for the study of chronic changes in the development of cardiac hypertrophy and its progression to heart failure. Heart failure models by surgical methods were originally developed in rats as these animals are most suitable for open chest surgical procedures, echocardiography and evaluation of hemodynamic parameters. They also provide adequate post mortem samples for tissue, cellular and molecular level studies1. Constriction of the ascending aorta is one of the most common and successful surgical models for creating pressure overload heart failure2,3. This model is well suited to study the cellular and sub cellular remodeling events and contractile properties of the heart during the transition from hypertrophy to heart failure4.
A major advantage of this model is the gradual onset of pressure overload on the heart5,6. This model is clinically relevant because of its slow but steady progression from compensated cardiac hypertrophy to decompensated phase and finally to the heart failure stage. The duration for progression of cardiac hypertrophy to heart failure and the associated physiological changes are mainly influenced by the degree of stenosis produced7. Ascending aortic constriction can be performed in two ways, either by using sutures or by application of metallic clips8,9. The main advantage of using a metallic clip for aortic constriction is that the surgical procedures are less complicated. In this method one has to locate the supra valvular ascending aorta and insert the clip around the aorta to obtain desired level of constriction. A chest retractor is not necessary in this procedure. Aortic banding by suturing requires more surgical manipulations for placing the gauge needle beside the ascending aorta and suturing around it to produce the desired level of aortic constriction. The latter technique is more time consuming when compared with the use of metallic clips for aortic constriction. The method described in this video demonstrates the surgical procedure for ascending aortic constriction in rats that allows creation of pressure overloaded left ventricular hypertrophy model.

<table border="0" cellpadding="0" cellspacing="0" width="742">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Wistar rats</td>
			<td style="width:149px;"></td>
			<td style="width:119px;"></td>
			<td style="width:220px;">Maintained at ARF, RGCB</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Inhalation anaesthesia systems&#160;</td>
			<td style="width:149px;">VetEquip</td>
			<td style="width:119px;">AB19276</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Rodent ventilator</td>
			<td style="width:149px;">CWE Inc</td>
			<td style="width:119px;">SAR- 830/AP&#160;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Rat tracheal cannula</td>
			<td style="width:149px;">CWE Inc</td>
			<td style="width:119px;">13-21032</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Ultrasound system</td>
			<td style="width:149px;">Philips</td>
			<td style="width:119px;">HD7</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Ultrasound transducer</td>
			<td style="width:149px;">Philips</td>
			<td style="width:119px;">S 12</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Titanium clip (small)</td>
			<td style="width:149px;">Horizon</td>
			<td style="width:119px;">1204</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Clip applicator</td>
			<td style="width:149px;">Weck</td>
			<td style="width:119px;">137081</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Electric shaver</td>
			<td style="width:149px;">Vinverth</td>
			<td style="width:119px;">VBT0817</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">BP blade (size:11)</td>
			<td style="width:149px;">Surgeon</td>
			<td style="width:119px;">REF10111</td>
			<td>Preparation of surgical site</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Tramadol</td>
			<td style="width:149px;">Orchid health care</td>
			<td style="width:119px;">OCH043</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Amoxycillin Hydrochloride</td>
			<td style="width:149px;">Ranbaxy</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Isoflurane</td>
			<td style="width:149px;">Piramal health care</td>
			<td style="width:119px;">A23M10A</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Syringes</td>
			<td style="width:149px;">BD</td>
			<td style="width:119px;">2015-09</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">4-0 braided silk</td>
			<td style="width:149px;">Diamond</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">3-0 prolene</td>
			<td style="width:149px;">Johnson&#38;Johnson</td>
			<td style="width:119px;">NW018</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Surgical tape</td>
			<td style="width:149px;">Romsons</td>
			<td style="width:119px;">SH 6301</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Povidone iodine</td>
			<td style="width:149px;">Win Medicare</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:255px;">Temp. controlled heating pad</td>
			<td style="width:149px;">Flamingo</td>
			<td style="width:119px;">HC1003</td>
			<td></td>
		</tr>
	</tbody>
</table>

ascending aortic constriction in rats for creation of pressure overload cardiac hypertrophy model

Ascending aortic constriction is the most common and successful surgical model for creating pressure overload induced cardiac hypertrophy and heart failure. Here, we describe a detailed surgical procedure for creating pressure overload and cardiac hypertrophy in rats by constriction of the ascending aorta using a small metallic clip. After anesthesia, the trachea is intubated by inserting a cannula through a half way incision made between two cartilage rings of trachea. Then a skin incision is made at the level of the second intercostal space on the left chest wall and muscle layers are cleared to locate the ascending portion of aorta. The ascending aorta is constricted to 50&#8211;60% of its original diameter by application of a small sized titanium clip. Following aortic constriction, the second and third ribs are approximated with prolene sutures. The tracheal cannula is removed once spontaneous breathing was re-established. The animal is allowed to recover on the heating pad by gradually lowering anesthesia. The intensity of pressure overload created by constriction of the ascending aorta is determined by recording the pressure gradient using trans-thoracic two dimensional Doppler-echocardiography. Overall this protocol is useful to study the remodeling events and contractile properties of the heart during the gradual onset and progression from compensated cardiac hypertrophy to heart failure stage.

In our experiments we are able to achieve more than 80% survival rates. The effectiveness of aortic constriction was confirmed by performing Doppler echocardiography. Rats (n=6) with a pressure gradient of about 60 mm of Hg at the aortic constricted site were observed for 8 weeks and sacrificed to analyze for the development of cardiac hypertrophy (Figure 1). After 8 weeks post-surgery echocardiographic evaluation revealed a significant increase in left ventricular parameters such as inter ventricular se...

Watch this Scientific Journal Video about Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model at JoVE.com

Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model

We describe a stepwise procedure for creating pressure overload and left ventricular hypertrophy in Wistar rats by constriction of the ascending aorta using a small metallic clip. This model is extensively used for studying remodeling changes during cardiac hypertrophy and for identifying and evaluating strategies for regression of such changes.

Ascending aortic constriction is the most common and successful surgical model for creating pressure overload induced cardiac hypertrophy and heart ...

ascending-aortic-constriction-rats-for-creation-pressure-overload

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17.0K Views.  Rajiv Gandhi Centre for Biotechnology. We describe a stepwise procedure for creating pressure overload and left ventricular hypertrophy in Wistar rats by constriction of the ascending aorta using a small metallic clip. This model is extensively used for studying remodeling changes during cardiac hypertrophy and for identifying and evaluating strategies for regression of such changes.

Video: Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model

Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow reserve (CFR) in humans. Reduced CFR is accompanied by marked intramyocardial and pericoronary fibrosis and is used as an indication of the severity of dysfunction. This study explores, step-by-step, the real-time changes measured in the coronary flow velocity, CFR and systolic to diastolic peak velocity (S/D) ratio in the setting of an aortic banding model in mice. By using a Doppler transthoracic imaging technique that yields reproducible and reliable data, the method assesses changes in flow in the septal coronary artery (SCA), for a period of over two weeks in mice, that previously either underwent aortic banding or thoracotomy. 
During imaging, hyperemia in all mice was induced by isoflurane, an anesthetic that increased coronary flow velocity when compared with resting flow. All images were acquired by a single imager. Two ratios, (1) CFR, the ratio between hyperemic and baseline flow velocities, and (2) systolic (S) to diastolic (D) flow were determined, using a proprietary software and by two independent observers. Importantly, the observed changes in coronary flow preceded LV dysfunction as evidenced by normal LV mass and fractional shortening (FS). 
The method was benchmarked against the current gold standard of coronary assessment, histopathology. The latter technique showed clear pathologic changes in the coronary artery in the form of peri-coronary fibrosis that correlated to the flow changes as assessed by echocardiography. 
The study underscores the value of using a non-invasive technique to monitor coronary circulation in mouse hearts. The method minimizes redundant use of research animals and demonstrates that advanced ultrasound-based indices, such as CFR and S/D ratios, can serve as viable diagnostic tools in a variety of investigational protocols including drug studies and the study of genetically modified strains.

Coronary flow reserve (CFR) is useful for assessment of myocardial oxygen demand and evaluation of cardiovascular risk. This study establishes a step-by-step transthoracic Doppler echocardiographic (TTDE) method for longitudinal monitoring of the changes in CFR, as measured from coronary artery in mice, under the experimental pressure overload of aortic banding.

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow ...

Assessment of Cardiac Morphological and Functional Changes in Mouse Model of Transverse Aortic Constriction by Echocardiographic Imaging

Transverse aortic constriction (TAC) in mice has been used as a valuable model to study mechanisms of cardiac hypertrophy and heart failure1. A reliable noninvasive method is essential to assess real-time cardiac morphological and functional changes in animal models of heart disease. Transthoracic echocardiography represents an important tool for noninvasive assessment of cardiac structure and function2. Here we used a high-resolution ultrasound imaging system to monitor myocardial remodeling and heart failure progression over time in a mouse model of TAC. B-mode, M-mode, and Doppler imaging were used to precisely assess cardiac hypertrophy, ventricular dilatation, and functional deterioration in mice following TAC. Color and pulse wave (PW) Doppler imaging was used to noninvasively measure pressure gradient across the aortic constriction created by TAC and to assess transmitral blood flow in mice. Thus transthoracic echocardiographic imaging provides comprehensive noninvasive measurements of cardiac dimensions and function in mouse models of heart disease.

The goal of this protocol is to noninvasively assess cardiac structural and functional changes in a mouse model of heart disease created by transverse aortic constriction, using B- and M-mode echocardiography and color/pulse wave Doppler imaging.

Transverse aortic constriction (TAC) in mice has been used as a valuable model to study mechanisms of cardiac hypertrophy and heart failure1. A reliable ...

A Model of Cardiac Remodeling Through Constriction of the Abdominal Aorta in Rats

Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and fluid retention. Changes in myocardial structure, electrical conduction, and energy metabolism develop with heart failure, leading to contractile dysfunction, increased risk of arrhythmias, and sudden death. Hypertensive heart disease is one of the key contributing factors of cardiac remodeling associated with heart failure. The most commonly-used animal model mimicking hypertensive heart disease is created via surgical interventions, such as by narrowing the aorta. Abdominal aortic constriction is a useful experimental technique to induce a pressure overload, which leads to heart failure. The surgery can be easily performed, without the need for chest opening or mechanical ventilation. Abdominal aortic constriction-induced cardiac pathology progresses gradually, making this model relevant to clinical hypertensive heart failure. Cardiac injury and remodeling can be observed 10 weeks after the surgery. The method described here provides a simple and effective approach to produce a hypertensive heart disease animal model that is suitable for studying disease mechanisms and for testing novel therapeutics.

A rat model of abdominal aortic constriction that induces cardiac hypertrophy and remodeling is described. An efficient, highly-reproducible, and minimally-invasive method is used to provide a simple yet useful platform for research in myocardial hypertrophy and dysfunction.

Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and ...

Minimally Invasive Transverse Aortic Constriction in Mice

Minimally invasive transverse aortic constriction (MTAC) is a more desirable method for the constriction of the transverse aorta in mice than standard open-chest transverse aortic constriction (TAC). Although transverse aortic constriction is a highly functional method for the induction of high pressure in the left ventricle, it is a more difficult and lengthy procedure due to its use of artificial ventilation with tracheal intubation. TAC is oftentimes also less survivable, as the newer method, MTAC, neither requires the cutting of the ribs and intercostal muscles nor tracheal intubation with a ventilation setup. In MTAC, as opposed to a thoracotomy to access to the chest cavity, the aortic arch is reached through a midline incision in the anterior neck. The thyroid is pulled back to reveal the sternal notch. The sternum is subsequently cut down to the second rib level, and the aortic arch is reached simply by separating the connective tissues and thymus. From there, a suture can be wrapped around the arch and tied with a spacer, and then the sternal cut and skin can be closed. MTAC is a much faster and less invasive way to induce left ventricular hypertension and enables the possibility for high-throughput studies. The success of the constriction can be verified using high-frequency trans-thoracic echocardiography, particularly color Doppler and pulsed-wave Doppler, to determine the flow velocities of the aortic arch and left and right carotid arteries, the dimension of the blood vessels, and the left ventricular function and morphology. A successful constriction will also trigger significant histopathological changes, such as cardiac muscle cell hypertrophy with interstitial and perivascular fibrosis. Here, the procedure of MTAC is described, demonstrating how the resulting flow changes in the carotid arteries can be examined with echocardiography, gross morphology, and histopathological changes in the heart.

Minimally invasive transverse aortic constriction (MTAC) conserves the essentials of regular transverse aortic constriction (TAC) while eliminating the use of a ventilator with tracheal intubation. It proves to be a highly desirable method for high-throughput studies on left ventricular overload, particularly in translational studies.

Minimally invasive transverse aortic constriction (MTAC) is a more desirable method for the constriction of the transverse aorta in mice than standard ...

Technique of Minimally Invasive Transverse Aortic Constriction in Mice for Induction of Left Ventricular Hypertrophy

Transverse aortic constriction (TAC) in mice is one of the most commonly used surgical techniques for experimental investigation of pressure overload-induced left ventricular hypertrophy (LVH) and its progression to heart failure. In the majority of the reported investigations, this procedure is performed with intubation and ventilation of the animal which renders it demanding and time-consuming and adds to the surgical burden to the animal. The aim of this protocol is to describe a simplified technique of minimally invasive TAC without intubation and ventilation of mice. Critical steps of the technique are emphasized in order to achieve low mortality and high efficiency in inducing LVH.
Male C57BL/6 mice (10-week-old, 25-30 g, n=60) were anesthetized with a single intraperitoneal injection of a mixture of ketamine and xylazine. In a spontaneously breathing animal following a 3-4 mm upper partial sternotomy, a segment of 6/0 silk suture threaded through the eye of a ligation aid was passed under the aortic arch and tied over a blunted 27-gauge needle. Sham-operated animals underwent the same surgical preparation but without aortic constriction. The efficacy of the procedure in inducing LVH is attested by a significant increase in the heart/body weight ratio. This ratio is obtained at days 3, 7, 14 and 28 after surgery (n = 6 - 10 in each group and each time point). Using our technique, LVH is observed in TAC compared to sham animals from day 7 through day 28. Operative and late (over 28 days) mortalities are both very low at 1.7%.
In conclusion, our cost-effective technique of minimally invasive TAC in mice carries very low operative and post-operative mortalities and is highly efficient in inducing LVH. It simplifies the operative procedure and reduces the strain put on the animal. It can be easily performed by following the critical steps described in this protocol.

The aim of this protocol is to describe step-by-step the technique of minimally invasive transverse aortic constriction (TAC) in mice. By elimination of intubation and ventilation which are mandatory for the commonly used standard procedure, minimally invasive TAC simplifies the operative procedure and reduces the strain put on the animal.

Transverse aortic constriction (TAC) in mice is one of the most commonly used surgical techniques for experimental investigation of pressure ...

A Closed-chest Model to Induce Transverse Aortic Constriction in Mice

Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to perform a partial thoracotomy to visualize the transverse aortic arch. However, the surgical trauma caused by the thoracotomy in open-chest models changes the respiratory physiology as the ribs are dissected and left unattached after chest closure. To prevent this, we established a minimally invasive, closed chest approach via lateral thoracotomy. Herein we approach the aortic arch via the 2nd intercostal space without entering the chest cavities, leaving the mouse with a less traumatic injury to recover from. We perform this operation using standard laboratory settings for open chest TAC procedures with equal survival rates. Apart from maintaining physiological breathing patterns due to the closed chest approach, the mice seem to benefit by showing rapid recovery, as the less invasive technique appears to facilitate a fast healing process and to reduce immune response after trauma.

Here, we present a protocol of Transverse Aortic constriction (TAC) via a lateral thoracotomy. This technique is a minimally invasive, closed chest surgical procedure aiming to simulate pressure overload and heart failure in mice utilizing standard TAC laboratory settings.

Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to ...

A Pulmonary Trunk Banding Model of Pressure Overload Induced Right Ventricular Hypertrophy and Failure

Right ventricular (RV) failure induced by sustained pressure overload is a major contributor to morbidity and mortality in several cardiopulmonary disorders. Reliable and reproducible animal models of RV failure are therefore warranted in order to investigate disease mechanisms and effects of potential therapeutic strategies. Banding of the pulmonary trunk is a common method to induce isolated RV hypertrophy but in general, previously described models have not succeeded in creating a stable model of RV hypertrophy and failure.
We present a rat model of pressure overload induced RV hypertrophy caused by pulmonary trunk banding (PTB) that enables different phenotypes of RV hypertrophy with and without RV failure. We use a modified ligating clip applier to compress a titanium clip around the pulmonary trunk to a pre-set inner diameter. We use different clip diameters to induce different stages of disease progression from mild RV hypertrophy to decompensated RV failure.
RV hypertrophy develops consistently in rats subjected to the PTB procedure and depending on the diameter of the applied banding clip, we can accurately reproduce different disease severities ranging from compensated hypertrophy to severe decompensated RV failure with extra-cardiac manifestations.
The presented PTB model is a valid and robust model of pressure overload induced RV hypertrophy and failure that has several advantages to other banding models including high reproducibility and the possibility of inducing severe and decompensated RV failure.

We present a surgical method to induce right ventricular hypertrophy and failure in rats.

Right ventricular (RV) failure induced by sustained pressure overload is a major contributor to morbidity and mortality in several cardiopulmonary ...

Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy

Based on twice transverse aortic constrictions (TACs) in mice, it is proved that myocardial hypertrophic preconditioning (MHP) could attenuate cardiomyocyte hypertrophy and slow down progression to heart failure. For novices, however, the MHP model is usually quite difficult to establish because of the technical obstacles in ventilator operation, opening the chest repeatedly, and bleeding caused by debanding. To facilitate this model, to increase the surgical success rate and to reduce the incidence of bleeding, we switched to absorbable sutures for the first TAC combing with a ventilator-free technique. Using a 2-week absorbable suture, we demonstrated that this procedure could cause significant myocardial hypertrophy in 2 weeks; and 4 weeks after surgery, myocardial hypertrophy was almost completely regressed to the baseline. Using this protocol, the operators could master the MHP model easily with a lower operation mortality.

This protocol presents an improved method to obtain transient myocardial hypertrophy with absorbable suture, simulating left ventricular hypertrophy decrease after removing pressure overload. It could be valuable for the studies on myocardial hypertrophic preconditioning.

Based on twice transverse aortic constrictions (TACs) in mice, it is proved that myocardial hypertrophic preconditioning (MHP) could attenuate ...

O-Ring Aortic Banding Versus Traditional Transverse Aortic Constriction for Modeling Pressure Overload-Induced Cardiac Hypertrophy

Aortic banding in mice is one of the most commonly used experimental models for cardiac pressure overload-induced cardiac hypertrophy and the induction of heart failure. The previously used technique is based on a threaded suture around the aortic arch tied over a blunted 27 G needle to create stenosis. This method depends on the surgeon manually tightening the thread and, thus, leads to high variance in the diameter size. A newly refined method described by Melleby et al. promises less variance and more reproducibility after surgery. The new technique, o-ring- aortic banding (ORAB), uses a non-slip rubber ring instead of a suture with a thread, resulting in reduced variation in pressure overload and reproducible phenotypes of cardiac hypertrophy. During surgery, the o-ring is placed between the brachiocephalic and left carotid arteries. Successful constriction is confirmed by echocardiography. After 1 day, correct placement of the ring results in an increased flow velocity in the transverse aorta over the o-ring-induced stenosis. After 2 weeks, impaired cardiac function is proven by decreased ejection fraction and increased wall thickness. Importantly, besides less variance in the diameter size, ORAB is associated with lower intra- and post-operative mortality rates compared with transverse aortic constriction (TAC). Thus, ORAB represents a superior method to the commonly used TAC surgery, resulting in more reproducible results and a possible reduction in the number of animals needed.

The present protocol describes a new technique of aortic banding in mice to induce pressure overload cardiac hypertrophy. For banding, a rubber ring with a fixed inner diameter is used. This new technique promises less variance and more reproducible data for future experiments.

Aortic banding in mice is one of the most commonly used experimental models for cardiac pressure overload-induced cardiac hypertrophy and the induction of ...

Modified Heterotopic Abdominal Heart Transplantation and a Novel Aortic Regurgitation Model in Rats

Over the past 50 years, many researchers have reported heterotopic abdominal heart transplantation in mice and rats, with some variations in the surgical technique. Modifying the transplantation procedure to strengthen the myocardial protection could prolong the ischemia time while preserving the donor&#39;s cardiac function. This technique&#39;s key points are as follows: transecting the donor&#39;s abdominal aorta before harvesting to unload the donor&#39;s heart; perfusing the donor&#39;s coronary arteries with a cold cardioplegic solution; and topical cooling of the donor&#39;s heart during the anastomosis procedure. Consequently, since this procedure prolongs the acceptable ischemia time, beginners can easily perform it and achieve a high success rate.
Moreover, a new aortic regurgitation (AR) model was established in this work using a technique different from the existing one,&#160;which is created by inserting a catheter from the right carotid artery and puncturing the native aortic valve under continuous echocardiographic guidance. A heterotopic abdominal heart transplantation was performed using the novel AR model. In the protocol, after the donor&#39;s heart is harvested, a stiff guidewire is inserted into the donor&#39;s brachiocephalic artery and advanced toward the aortic root. The aortic valve is punctured by pushing the guidewire further even after the resistance is felt, thus inducing AR. It is easier to damage the aortic valve using this method than with the procedure described in the conventional AR model. Additionally, this novel AR model does not contribute to the recipient&#39;s circulation; therefore, this method is expected to produce a more severe AR model than the conventional procedure.

This study demonstrates a reproducible heterotopic abdominal heart transplantation technique in rats that beginners can learn and perform. Additionally, a novel aortic regurgitation model in rats is generated by performing heterotopic abdominal heart transplantation and damaging the donor's aortic valve using a guidewire after harvesting.

Over the past 50 years, many researchers have reported heterotopic abdominal heart transplantation in mice and rats, with some variations in the surgical ...