Neto-Neves, Evandro M.Brown, Mary B.Zaretskaia, Maria V.Rezania, SaminGoodwill, Adam G.McCarthy, Brian P.Persohn, Scott A.Territo, Paul R.Kline, Jeffrey A.2018-08-012018-08-012017-04Neto-Neves, E. M., Brown, M. B., Zaretskaia, M. V., Rezania, S., Goodwill, A. G., McCarthy, B. P., … Kline, J. A. (2017). Chronic Embolic Pulmonary Hypertension Caused by Pulmonary Embolism and Vascular Endothelial Growth Factor Inhibition. The American Journal of Pathology, 187(4), 700–712. http://doi.org/10.1016/j.ajpath.2016.12.004https://hdl.handle.net/1805/16915Our understanding of the pathophysiological basis of chronic thromboembolic pulmonary hypertension (CTEPH) will be accelerated by an animal model that replicates the phenotype of human CTEPH. Sprague-Dawley rats were administered a combination of a single dose each of plastic microspheres and vascular endothelial growth factor receptor antagonist in polystyrene microspheres (PE) + tyrosine kinase inhibitor SU5416 (SU) group. Shams received volume-matched saline; PE and SU groups received only microspheres or SU5416, respectively. PE + SU rats exhibited sustained pulmonary hypertension (62 ± 13 and 53 ± 14 mmHg at 3 and 6 weeks, respectively) with reduction of the ventriculoarterial coupling in vivo coincident with a large decrement in peak rate of oxygen consumption during aerobic exercise, respectively. PE + SU produced right ventricular hypokinesis, dilation, and hypertrophy observed on echocardiography, and 40% reduction in right ventricular contractile function in isolated perfused hearts. High-resolution computed tomographic pulmonary angiography and Ki-67 immunohistochemistry revealed abundant lung neovascularization and cellular proliferation in PE that was distinctly absent in the PE + SU group. We present a novel rodent model to reproduce much of the known phenotype of CTEPH, including the pivotal pathophysiological role of impaired vascular endothelial growth factor-dependent vascular remodeling. This model may reveal a better pathophysiological understanding of how PE transitions to CTEPH in human treatments.en-USPublisher PolicyCardiomegalyCell proliferationChronic diseaseHeart function testsHemodynamicsHyperplasiaHypertension, PulmonaryHypoxiaIndolesKi-67 antigenMicrospheresOxygen consumptionPartial pressurePlasminogen activator inhibitor 1Pulmonary embolismTissue Inhibitor of metalloproteinase-1Vascular endothelial growth factor AVentricular dysfunctionArticle