Isolated right ventricular pressure overload induced hypertrophy without failure, whereas angioproliferative pulmonary hypertension caused RV failure that was prevented by the supplement Protandim.
Does induction of Nrf2 and HO-1 with Protandim prevent right ventricular failure in animal models of pulmonary hypertension?
Right ventricular failure in pulmonary hypertension is not solely due to increased afterload, and inducing Nrf2/HO-1 can preserve RV function and prevent fibrosis in preclinical models.
Background— The most important determinant of longevity in pulmonary arterial hypertension is right ventricular (RV) function, but in contrast to experimental work elucidating the pathobiology of left ventricular failure, there is a paucity of data on the cellular and molecular mechanisms of RV failure. Methods and Results— A mechanical animal model of chronic progressive RV pressure overload (pulmonary artery banding, not associated with structural alterations of the lung circulation) was compared with an established model of angioproliferative pulmonary hypertension associated with fatal RV failure. Isolated RV pressure overload induced RV hypertrophy without failure, whereas in the context of angioproliferative pulmonary hypertension, RV failure developed that was associated with myocardial apoptosis, fibrosis, a decreased RV capillary density, and a decreased vascular endothelial growth factor mRNA and protein expression despite increased nuclear stabilization of hypoxia-induced factor-1α. Induction of myocardial nuclear factor E2-related factor 2 and heme-oxygenase 1 with a dietary supplement (Protandim) prevented fibrosis and capillary loss and preserved RV function despite continuing pressure overload. Conclusion— These data brought into question the commonly held concept that RV failure associated with pulmonary hypertension is due strictly to the increased RV afterload.
Bogaard et al. (2009) studied Pulmonary arterial hypertension and right ventricular failure. Protandim (dietary supplement) vs. Angioproliferative pulmonary hypertension model was evaluated on Right ventricular failure, myocardial apoptosis, fibrosis, and capillary density. Isolated right ventricular pressure overload induced hypertrophy without failure, whereas angioproliferative pulmonary hypertension caused RV failure that was prevented by the supplement Protandim.
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