The effect of nitric oxide inhalation on heart and pulmonary circulation in rabbits with acute massive pulmonary embolism

Zhang,Zeming; Pan,Kun; Chen,Lu; Wang,Yancun

doi:10.3892/etm.2018.6155

The effect of nitric oxide inhalation on heart and pulmonary circulation in rabbits with acute massive pulmonary embolism

Authors:
- Zeming Zhang
- Kun Pan
- Lu Chen
- Yancun Wang
View Affiliations

Affiliations: Department of Respiratory Medicine, Affiliated Zhou Pu Hospital of Shanghai Health College, Shanghai 201318, P.R. China, Department of Respiratory Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China
Published online on: May 11, 2018 https://doi.org/10.3892/etm.2018.6155
Pages: 270-276
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to investigate the effect of nitric oxide inhalation (NOI) on cardiac troponin I (CTnI) levels and mean pulmonary arterial pressure (mPAP) in rabbits with acute massive pulmonary embolism (AMPE). Thirty rabbits were used as animal models for AMPE and received different treatments. A total of 4 h after successful modeling, the control group (CON, n=10) received conventional thrombolysis, whereas the treatment group (TRE, n=10) received conventional thrombolysis plus NOI. The experimental group (EXP, n=10) did not receive any treatments. Myocardial necrosis was pathologically confirmed in all 30 rabbits. In group EXP, the post‑AMPE CTnI peak level was 0.42±0.12 µg/l, was achieved in 18.8±4.5 h and remained positive for 38.6±5.2 h (≥0.1 µg/l). These values were lower in group TRE when compared with those in groups CON and EXP (P<0.05). Group TRE exhibited significantly reduced mPAP at 24, 28, 32, and 34 h (P<0.05) when compared with group CON. AMPE‑induced cardiac impairment was more severe in group EXP when compared with groups CON and TRE. The present findings indicated that the CTnI peak was significantly correlated with the corresponding mPAP. Furthermore, the results suggested NOI may reduce mPAP and CTnI peak levels, with protective effects against AMPE‑induced myocardial damage in rabbits.

View Figures

View References

1	Darze ES, Casqueiro JB, Ciuffo LA, Santos JM, Magalhães IR and Latado AL: Pulmonary embolism mortality in Brazil from 1989 to 2010: Gender and regional disparities. Arq Bras Cardiol. 106:4–12. 2016.PubMed/NCBI
2	Yavuz S, Toktas F, Goncu T, Eris C, Gucu A, Ay D, Erdolu B, Tenekecioglu E, Karaagac K, Vural H and Ozyazicioglu A: Surgical embolectomy for acute massive pulmonary embolism. Int J Clin Exp Med. 7:5362–5375. 2014.PubMed/NCBI
3	Dalen JE and Alpert JS: Natural history of pulmonary embolism. Prog Cardiovasc Dis. 17:259–270. 1975. View Article : Google Scholar : PubMed/NCBI
4	Soloff A and Rodman T: Acute pulmonary embolism. II. Clinical. Am Heart J. 74:829–847. 1967. View Article : Google Scholar : PubMed/NCBI
5	Jones AE, Watts JA, Debelak JP, Thornton LR, Younger JG and Kline JA: Inhibition of prostaglandin synthesis during polystyrene microsphere-induced pulmonary embolism in the rat. Am J Physiol Lung Cell Mol Physiol. 284:L1072–L1081. 2003. View Article : Google Scholar : PubMed/NCBI
6	Cho JH, Sridharan Kutti G, Kim SH, Kaw R, Abburi T, Irfan A and Kocheril AG: Right ventricular dysfunction as an echocardiographic prognostic factor in hemodynamically stable patients with acute pulmonary embolism: A meta-analysis. BMC Cardiovasc Disord. 14:642014. View Article : Google Scholar : PubMed/NCBI
7	Meyer T, Binder L, Hruska N, Luthe H and Buchwald AB: Cardiac troponin I elevation in acute pulmonary embolism is associated with right ventricular dysfunction. J Am Coll Cardiol. 36:1632–1636. 2000. View Article : Google Scholar : PubMed/NCBI
8	French Intensive Care Society, . International congress-Réanimation 2016. Ann Intensive Care. 6 Suppl 1:S502016. View Article : Google Scholar
9	Kreit JW: The impact of right ventricular dysfunction on the prognosis and therapy of normotensive patients with pulmonary embolism. Chest. 125:1539–1545. 2004. View Article : Google Scholar : PubMed/NCBI
10	Kline JA, Hernandez J, Garrett JS and Jones AE: Pilot study of a protocol to administer inhaled nitric oxide to treat severe acute submassive pulmonary embolism. Emerg Med J. 31:459–462. 2014. View Article : Google Scholar : PubMed/NCBI
11	Trummer G, Berchtold-Herz M, Martin J and Beyersdorf F: Successful treatment of pulmonary hypertension with inhaled nitric oxide after pulmonary embolectomy. Ann Thorac Surg. 73:1299–1301. 2012. View Article : Google Scholar
12	Waldow T, Witt W, Janke A, Ulmer A, Buzin A and Matschke K: Cell-cell junctions and vascular endothelial growth factor in rat lung as affected by ischemia/reperfusion and preconditioning with inhaled nitric oxide. J Surg Res. 157:30–42. 2009. View Article : Google Scholar : PubMed/NCBI
13	Qi Y, Qian L, Sun B, Liu L, Wu P and Sun L: Inhaled NO contributes to lung repair in piglets with acute respiratory distress syndrome via increasing circulating endothelial progenitor cells. PLoS One. 7:e338592012. View Article : Google Scholar : PubMed/NCBI
14	Strijdom H, Chamane N and Lochner A: Nitric oxide in the cardiovascular system: A simple molecule with complex actions. Cardiovasc J Afr. 20:303–310. 2009.PubMed/NCBI
15	Elias A, Mallett S, Daoud-Elias M, Poggi JN and Clarke M: Prognostic models in acute pulmonary embolism: A systematic review and meta-analysis. BMJ Open. 6:e0103242016. View Article : Google Scholar : PubMed/NCBI
16	Müller-Bardorff M, Weidtmann B, Giannitsis E, Kurowski V and Katus HA: Release kinetics of cardiac troponin T in survivors of confirmed severe pulmonary embolism. Clin Chem. 48:673–675. 2002.PubMed/NCBI
17	Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, et al: Heart disease and stroke statistics-2014 update: A report from the American Heart Association. Circulation. 129:e28–e292. 2014. View Article : Google Scholar : PubMed/NCBI
18	Zagorski J, Gellar MA, Obraztsova M, Kline JA and Watts JA: Inhibition of CINC-1 decreases right ventricular damage caused by experimental pulmonary embolism in rats. J Immunol. 179:7820–7826. 2007. View Article : Google Scholar : PubMed/NCBI
19	Lannan KL, Phipps RP and White RJ: Thrombosis, platelets, microparticles and PAH: More than clot. Drug Discov Today. 19:1230–1235. 2014. View Article : Google Scholar : PubMed/NCBI
20	von Brühl ML, Stark K, Steinhart A, Chandraratne S, Konrad I, Lorenz M, Khandoga A, Tirniceriu A, Coletti R, Köllnberger M, et al: Monocytes, neutrophils, and platelets cooperate to initiate and propagate venous thrombosis in mice in vivo. J Exp Med. 209:819–835. 2012. View Article : Google Scholar : PubMed/NCBI
21	Sullivan DM, Watts JA and Kline JA: Biventricular cardiac dysfunction after acute massive pulmonary embolism in the rat. J Appl Physiol (1985). 90:1648–1656. 2001. View Article : Google Scholar : PubMed/NCBI
22	Montani D, Günther S, Dorfmüller P, Perros F, Girerd B, Garcia G, Jaïs X, Savale L, Artaud-Macari E, Price LC, et al: Pulmonary arterial hypertension. Orphanet J Rare Dis. 8:972013. View Article : Google Scholar : PubMed/NCBI
23	Xu Q, Huang K, Zhai Z, Yang Y, Wang J and Wang C: Initial thrombolysis treatment compared with anticoagulation for acute intermediate-risk pulmonary embolism: A meta-analysis. J Thorac Dis. 7:810–821. 2015.PubMed/NCBI
24	Tanus-Santos JE and Moreno H Jr: The use of inhaled nitric oxide during gas embolism. Chest. 115:1220–1221. 1999. View Article : Google Scholar : PubMed/NCBI
25	Yang Y, Feng Y, Zhou XG, Pan JJ and Zhou XY: Inhaled nitric oxide in preterm infants: An updated meta-analysis. J Res Med Sci. 21:412016. View Article : Google Scholar : PubMed/NCBI
26	Nong Z, Hoylaerts M, Van Pelt N, Collen D and Janssens S: Nitric oxide inhalation inhibits platelet aggregation and platelet-mediated pulmonary thrombosis in rats. Circ Res. 81:865–869. 1997. View Article : Google Scholar : PubMed/NCBI