Affiliation:
1. Vascular Research Laboratory Providence VA Medical Center Providence Rhode Island USA
2. Division of Cardiology, Department of Medicine Alpert Medical School of Brown University Providence Rhode Island USA
3. Pulmonary Division, Heart Institute University of São Paulo Medical School São Paulo Brazil
4. Medical Education Edward Via College of Osteopathic Medicine Auburn Alabama USA
5. Biomedical and Pharmaceutical Sciences University of Rhode Island Kingston Rhode Island USA
Abstract
AbstractReduced exercise capacity in pulmonary hypertension (PH) significantly impacts quality of life. However, the cause of reduced exercise capacity in PH remains unclear. The objective of this study was to investigate whether intrinsic skeletal muscle changes are causative in reduced exercise capacity in PH using preclinical PH rat models with different PH severity. PH was induced in adult Sprague–Dawley (SD) or Fischer (CDF) rats with one dose of SU5416 (20 mg/kg) injection, followed by 3 weeks of hypoxia and additional 0–4 weeks of normoxia exposure. Control rats were injected with vehicle and housed in normoxia. Echocardiography was performed to assess cardiac function. Exercise capacity was assessed by VO2 max. Skeletal muscle structural changes (atrophy, fiber type switching, and capillary density), mitochondrial function, isometric force, and fatigue profile were assessed. In SD rats, right ventricular systolic dysfunction is associated with reduced exercise capacity in PH rats at 7‐week timepoint in comparison to control rats, while no changes were observed in skeletal muscle structure, mitochondrial function, isometric force, or fatigue profile. CDF rats at 4‐week timepoint developed a more severe PH and, in addition to right ventricular dysfunction, the reduced exercise capacity in these rats is associated with skeletal muscle atrophy; however, mitochondrial function, isometric force, and fatigue profile in skeletal muscle remain unchanged. Our data suggest that cardiopulmonary impairments in PH are the primary cause of reduced exercise capacity, which occurs before intrinsic skeletal muscle dysfunction.
Funder
U.S. Department of Veterans Affairs
National Heart, Lung, and Blood Institute
National Institute of General Medical Sciences