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pulmonary hypertension in rats with congenital diaphragmatic hernia is a chronic, progressive, and lethal disorder characterized by severe pulmonary arterial hypertension and pulmonary vascular remodeling that leads to right ventricular failure and death. pulmonary hypertension is the most common cause of death in congenital diaphragmatic hernia survivors and in the absence of intervention, all patients die by one year of life. this research was designed to assess the effects of two different doses of inhaled nitric oxide (no) on the development of pulmonary hypertension in the late stage of congenital diaphragmatic hernia. we studied nine neonatal rats born to dams exposed to 60mg/l of a synthetic hormone, ethinyl estradiol, in the drinking water from day 15 of gestation through parturition. these rats were assigned to either a control group (n=3) or an experimental group (n=6). the experimental group was exposed to a lower concentration of inhaled no (6ppm) from postnatal day 5 until the experimental endpoint at postnatal day 28, which was defined as the time at which a drop of 500g in body weight or the inability to right itself was observed. the control group was exposed to the same concentration of inhaled no for the same time period. in the experimental group, there was a significant decrease in right ventricular systolic pressure from 62.6+/-4.3mmhg on postnatal day 5 to 44.6+/-3.4mmhg on postnatal day 28, and the left ventricular systolic pressure also decreased, from 45.8+/-6.3mmhg on postnatal day 5 to 30.3+/-4.2mmhg on postnatal day 28. in the control group, there was no change in right ventricular systolic pressure from postnatal day 5 to 28 (67.3+/-8.7mmhg to 71.0+/-6.3mmhg) and no decrease in left ventricular systolic pressure from postnatal day 5 to 28 (45.5+/-3.7mmhg to 53.8mmhg). we also assessed the morphology of the pulmonary vasculature in these animals. in the experimental group, there was a decrease in the total vascular bed from 8.3+/-0.5 to 4.7+/-0.4mm2, and a decrease in the external vascular surface area from 2.2+/-0.1 to 1.2mm2.
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