Pulmonary arterial hypertension (ascites syndrome) in broilers: a review

Pulmonary arterial hypertension (PAH) syndrome in broilers (also known as ascites syndrome and pulmonary hypertension syndrome) can be attributed to imbalances between cardiac output and the anatomical capacity of the pulmonary vasculature to accommodate ever-increasing rates of blood flow, as well as to an inappropriately elevated tone (degree of constriction) maintained by the pulmonary arterioles. Comparisons of PAH-susceptible and PAH-resistant broilers do not consistently reveal differences in cardiac output, but PAH-susceptible broilers consistently have higher pulmonary arterial pressures and pulmonary vascular resistances compared with PAH-resistant broilers. Efforts clarify the causes of excessive pulmonary vascular resistance have focused on evaluating the roles of chemical mediators of vasoconstriction and vasodilation, as well as on pathological (structural) changes occurring within the pulmonary arterioles (e.g., vascular remodeling and pathology) during the pathogenesis of PAH. The objectives of this review are to (1) summarize the pathophysiological progression initiated by the onset of pulmonary hypertension and culminating in terminal ascites; (2) review recent information regarding the factors contributing to excessively elevated resistance to blood flow through the lungs; (3) assess the role of the immune system during the pathogenesis of PAH; and (4) present new insights into the genetic basis of PAH. The cumulative evidence attributes the elevated pulmonary vascular resistance in PAH-susceptible broilers to an anatomically inadequate pulmonary vascular capacity, to excessive vascular tone reflecting the dominance of pulmonary vasoconstrictors over vasodilators, and to vascular pathology elicited by excessive hemodynamic stress. Emerging evidence also demonstrates that the pathogenesis of PAH includes characteristics of an inflammatory/autoimmune disease involving multifactorial genetic, environmental, and immune system components. Pulmonary arterial hypertension susceptibility appears to be multigenic and may be manifested in aberrant stress sensitivity, function, and regulation of pulmonary vascular tissue components, as well as aberrant activities of innate and adaptive immune system components. Major genetic influences and high heritabilities for PAH susceptibility have been demonstrated by numerous investigators. Selection pressures rigorously focused to challenge the pulmonary vascular capacity readily expose the genetic basis for spontaneous PAH in broilers. Chromosomal mapping continues to identify regions associated with ascites susceptibility, and candidate genes have been identified. Ongoing immunological and genomic investigations are likely to continue generating important new knowledge regarding the fundamental biological bases for the PAH/ascites syndrome.

Physiological, management and environmental triggers of the ascites syndrome: a review

In meat-type chickens, an inadequacy of vascular capacity for blood flow through the lung to provide the tissues with the oxygen needed for rapid growth is the primary cause of pulmonary hypertensioninduced ascites. There are a variety of other factors that can trigger the ascites syndrome. These factors may cause increased blood flow because of a higher metabolic rate (cold, heat, certain nutrients, chemicals, etc.) or they may cause pulmonary hypertension-induced ascites in rapidly growing chickens because of greater resistance to blood flow in the lung by: (i) increased blood viscosity or red blood cell rigidity; or (ii) reduced vascular capacity in the lung. Some secondary factors, such as high sodium from salt in feed or water, may cause both increased flow and increased resistance to flow. Measures to reduce the ascites syndrome must address the primary genetic cause of insufficient vascular flow capacity in the lung and oxygen delivery to tissues, and the secondary factors that increase oxygen requirement, blood flow and the resistance to blood flow in the lung.

Blood gas values and pulmonary hypertension as affected by dietary sodium source in broiler chickens reared at cool temperature in a high-altitude area

One hundred and twenty day-old male chicks (Ross 308) reared at a cool temperature at high altitude were subjected to the following two treatments in a completely randomised design: (1) a group for which the sodium requirements were supplied by sodium chloride from day-old age and regarded as control, (2) a group similar to the control but for which 50% of the sodium requirements was supplied by sodium bicarbonate from day-old age. Provision of sodium equally from NaCl and NaHCO₃ significantly (P < 0.05) increased the partial pressure of oxygen and the saturation of haemoglobin with oxygen, and significantly (P < 0.05) decreased the heterophil to lymphocyte ratio. The right ventricle to total ventricles ratio shifted to lower values as a result of substituting NaHCO₃ for NaCl as a sodium source. Growth performance and carcass characteristics were not affected significantly by the dietary sodium source.

Dietary sodium bicarbonate, cool temperatures, and feed withdrawal: impact on arterial and venous blood-gas values in broilers

Sodium bicarbonate (NaHCO3) has been used successfully in mammals and birds to alleviate pulmonary hypertension. Experiment 1 was designed to provide measurements of arterial and venous blood-gas values from unanesthetized male broilers subjected to a cool temperature (16 degrees C) challenge and fed either a control diet or the same diet alkalinized by dilution with 1% NaHCO3. The incidences of pulmonary hypertension syndrome (PHS, ascites) for broilers fed the control or bicarbonate diets were 15.5 and 10.5%, respectively (P = 0.36, NS). Non-ascitic broilers fed the control diet were heavier than those fed the bicarbonate diet on d 49 (2,671 vs. 2,484 g, respectively); however, other comparisons failed to reveal diet-related differences in heart weight, pulse oximetry values, electrocardiogram amplitudes, or blood-gas values (P > 0.05). When the data were resorted into categories based on right:total ventricular weight ratios (RV:TV) indicative of normal (RV:TV < 0.28) or elevated (RV:TV > or = 0.28) pulmonary arterial pressures, broilers with elevated RV:TV ratios had poorly oxygenated arterial blood that was more acidic, had high partial pressure of CO2 (PCO2), and had higher HCO3 concentrations when compared with broilers with normal RV:TV ratios. Experiment 2 was conducted to determine if metabolic variations associated with differences in feed intake or environmental temperature potentially could mask an impact of diet composition on blood-gas values. Male broilers maintained at thermoneutral temperature (24 degrees C) either received feed ad libitum or had the feed withdrawn > or = 12 h prior to blood sampling. Broilers fed ad libitum had lower venous saturation of hemoglobin with O2, higher venous PCO2, and higher arterial HCO3 concentrations than broilers subjected to feed withdrawal. Broilers in experiment 2 fed ad libitum and exposed to cool temperatures (16 degrees C) had lower arterial partial pressure of O2 and higher venous PCO2 than broilers fed ad libitum and maintained at 24 degrees C. Overall, these results demonstrate that changes in diet composition (control vs. 1% NaHCO3 diets) had minimal impact on arterial and venous blood-gas variables when compared with the more dramatic differences associated with feed intake (ad libitum vs. > or = 12 h withdrawal), environmental temperature (24 vs. 16 degrees C), and the pathogenesis associated with PHS (RV:TV < 0.28 vs. > or = 0.28).

The effect of dietary chloride and bicarbonate on blood pH, haematological variables, pulmonary hypertension and ascites in broiler chickens

1. The effect of supplementing grower diets with bicarbonate or chloride on haematological variables, pulmonary hypertension syndrome and ascites in broilers exposed to cold temperature was investigated. 2. High concentrations of dietary chloride had no effect on the pH of the venous blood but a low chloride/high bicarbonate diet significantly increased blood pH. There was no consistent effect of dietary chloride or bicarbonate concentrations on growth performance, although in 1 experiment birds given a low chloride/high bicarbonate diet consumed less food and gained less weight than controls. 3. Birds fed on high-chloride diets tended to have a higher incidence of ascites and pulmonary hypertension than controls. Birds fed on low-chloride and high-bicarbonate diets had significantly lower pulmonary hypertension and lower heart weights, which may have indicated a decrease in pulmonary and systemic blood pressure. 4. We conclude that increasing dietary bicarbonate and reducing dietary chloride has potential as a low cost and effective method to reduce the pulmonary hypertension which leads to ascites in broiler chickens.

Cardio-pulmonary function in preascitic (hypoxemic) or normal broilers inhaling ambient air or 100% oxygen

We evaluated the influence of the percentage saturation of hemoglobin with oxygen (HbO2) on the pulmonary arterial pressure in normal and preascitic (hypoxemic) broilers breathing ambient air or 100% O2. In Experiment 1, unanesthetized preascitic broilers (right:total ventricular weight ratios [RV:TV] = 0.32+/-0.02) breathing ambient air had initial values of 67% for HbO2 and 32 mm Hg for pulmonary arterial pressure. The HbO2 increased to > or =96.6% during inhalation of 100% O2; however, pulmonary arterial pressure was not reduced. In Experiment 2, anesthetized normal (RV:TV = 0.23; HbO2 = 88%) and preascitic broilers (RV:TV = 0.28; HbO2 = 76%) were compared. The groups did not differ in body weight or respiratory rate, but preascitic broilers had lower values for mean arterial pressure, total peripheral resistance, and partial pressure of O2 in arterial blood and had higher values for pulmonary arterial pressure. Inhaling 100% O2 increased HbO2 to 99.9% in both groups; however, pulmonary arterial pressure remained higher in preascitic than in normal broilers, and the pulmonary vascular resistance was not reduced during 100% O2 inhalation. Cardiac output was higher in preascitic than in normal broilers before and after, but not during, 100% O2 inhalation. Mean arterial pressure and total peripheral resistance increased in the preascitic but not in the normal group during 100% O2 inhalation. Low coefficients of determination (R2) were obtained for linear regression comparisons of HbO2 vs. pulmonary arterial pressure in both experiments. Overall, acute reversal of the systemic hypoxemia in preascitic broilers had little direct impact on pulmonary hypertension, providing no evidence of hypoxemic or hypoxic pulmonary vasoconstriction. Instead, acute reversal of the systemic hypoxemia primarily increased the total peripheral resistance and normalized the mean arterial pressure and cardiac output. A sustained reduction in cardiac output theoretically should attenuate pulmonary hypertension, but this was not observed because of the overriding influence of sustained pulmonary vascular resistance.

Renal responses of normal and preascitic broilers to systemic hypotension induced by unilateral pulmonary artery occlusion

During the pathophysiological progression of pulmonary hypertension syndrome (PHS; ascites), broilers concurrently develop systemic hypotension (low mean systemic arterial pressure) that may initiate renal retention of water and solute, contributing to fluid accumulation in the abdominal cavity (ascites). In male Single Comb White Leghorns, glomerular filtration is autoregulated over a systemic arterial pressure range of 110 to 60 mm Hg, and corresponding reductions in urine flow are attributed to a phenomenon known as pressure natriuresis. Acute unilateral pulmonary artery occlusion was used in the present study to reduce systemic arterial pressure toward the lower autoregulatory limit for glomerular filtration, and to evaluate kidney function in normal and preascitic broilers. Preascitic broilers characteristically exhibited lower (P < or = 0.05) values for mean systemic arterial pressure (91 vs 100 mm Hg) and percentage saturation of hemoglobin with oxygen (73 vs 84%), higher hematocrits (35 vs 30%), heavier right ventricles (3.44 vs 2.32 g), and higher right:total ventricular weight ratios (0.32 vs 0.24) than normal broilers. Body weights (2,445 vs 2,429 g, respectively), left ventricle plus septum weights (7.16 vs 7.19 g), and heart rates (349 vs 341 beats/min) were similar. Preascitic broilers exhibited larger (P < or = 0.05) dependent reductions in glomerular filtration, urine flow, osmolal clearance, and solute excretion and had a higher free water clearance than normal broilers in response to pulmonary artery occlusion. The differences observed between normal and preascitic broilers demonstrate that systemic hypotension can trigger renal mechanisms contributing to fluid and solute retention during development of PHS.

Venous blood pressure in broilers during acute inhalation of five percent carbon dioxide or unilateral pulmonary artery occlusion

We evaluated the hypothesis that venous congestion (increased venous volume), as reflected by venous hypertension (increased venous pressure), can arise when the right ventricle is unable to elevate the pulmonary arterial pressure sufficiently to propel the cardiac output through an anatomically inadequate or inappropriately constricted pulmonary vasculature. Changes in venous pressure were evaluated in clinically healthy broilers during modest increases in pulmonary vascular resistance induced by inhalation of 5% CO2 and during large increases in pulmonary vascular resistance accomplished by acutely tightening a snare around one pulmonary artery. Inhalation of 5% CO2 induced a pronounced respiratory acidosis, as reflected by increases the partial pressure of CO2 and the hydrogen ion concentration in arterial blood. Inhalation of 5% CO2 also increased pulmonary arterial pressure by approximately 3 mm Hg and increased venous pressure by approximately 1 mm Hg when compared with the pre-inhalation venous pressure. Tightening the pulmonary artery snare increased the pulmonary arterial pressure by approximately 10 mm Hg, and this degree of pulmonary hypertension was sustained until the snare was released. When compared with the pre- and post-snare intervals, tightening of the pulmonary artery snare induced a sustained increase in venous pressure of > or = 1 mm Hg. Veins have highly compliant walls that permit an approximate doubling in volume with only small (4 to 6 mm Hg) increases in central venous pressure. Presumably the apparently modest 1 mm Hg increase in venous pressure measured after CO2 inhalation or unilateral pulmonary artery occlusion reflects a large increase in venous volume and, thus, substantial venous congestion. These observations support the hypothesis that increases in pulmonary vascular resistance can initiate increases in venous pressure by challenging the capacity of the right ventricle to propel all of the returning venous blood through the lungs. Central venous congestion predisposes broilers to the onset of cirrhosis and ascites by impeding the outflow of hepatic venous blood and increasing the hydrostatic pressure within hepatic sinusoids.

Thromboxane mimics the pulmonary but not systemic vascular responses to bolus HCl injections in broiler chickens

Bolus i.v. injections of 1.2 N HCl elicit a rapid but transient pulmonary vasoconstriction in broiler chickens. In mammals, the pulmonary vasoconstrictive response to bolus acid injection depends on increased synthesis of thromboxane A2; however, the vascular responsiveness of domestic fowl to thromboxane previously had not been evaluated. In the present study, we tested the hypothesis that, if HCl triggers pulmonary vasoconstriction by stimulating thromboxane A2 synthesis in broilers, then bolus i.v. injections of the potent thromboxane A2 mimetic U44069 (9,11-dideoxy-9alpha,11alpha-epoxy-methanoprostaglandin++ + F2alpha; 1 micromol/mL; 0.5 mL injected volume) should trigger hemodynamic responses similar to those elicited by HCl (1.2 N; 1.5 mL injected volume). Both HCl and the thromboxane mimetic elicited twofold or greater increases in pulmonary vascular resistance, which in turn increased pulmonary arterial pressure by 50% despite concurrent reductions in cardiac output. The reductions in cardiac output were associated with reductions in stroke volume but not heart rate. The thromboxane mimetic also increased the total peripheral resistance, which minimized the reduction in mean systemic arterial pressure associated with the decrease in cardiac output. In contrast, HCl injections did not increase total peripheral resistance; consequently, the reduction in cardiac output caused the mean systemic arterial pressure to decrease by 30 mm Hg. Mannitol (2.5%; 1.5 mL) was injected i.v. as a volume control, and had no influence on any of the variables. This study provides the first direct evidence that thromboxane is a potent pulmonary vasoconstrictor in broilers, and provides support for the hypothesis that thromboxane mediates the pulmonary vasoconstrictive response to bolus i.v. injections of HCl. The differential response of the systemic vasculature to the thromboxane mimetic and HCl may indicate that cardiopulmonary responses to HCl injections are not mediated solely via thromboxane production. Alternatively, a direct dilatory effect of elevated hydrogen ion concentrations on the systemic vasculature may have counteracted any tendency for simultaneously evolved endogenous thromboxane to elicit systemic vasoconstriction.

Comparative effects of added sodium chloride, ammonium chloride, or potassium bicarbonate in the drinking water of broilers, and feed restriction, on the development of the ascites syndrome

A hypothesis that the ionic composition of drinking water might affect development of the ascites syndrome in broilers was investigated in two trials. The first trial comprised four groups of 650 male chicks. A control treatment was normal tap water and the other three treatments comprised the addition to the tap water of 1,000 mg/L sodium as NaCl, 5,000 mg/L NH4Cl, or 5,000 mg/L KHCO3, supplied from age 2 to 47 d. At Day 28, equally sized subsets of these groups were moved to individual cages, where they received a severe exposure to ambient cold. The development of the ascites syndrome was monitored by measurements of hematocrit and arterial blood oxygen saturation (PaO2) by oximetry, body weight, and examination of dead birds for cause of death. Mortality from ascites in cold-exposed birds from Days 28 to 47 was 28, 48, 40, and 16% in the tap water, NaCl, NH4Cl, and KHCO3 groups, respectively; only the NaCl mortality was significantly different from the tap water mortality. The KHCO3 treatment increased PaO2 (compared with tap water treatment) at Day 28 by 5.5% and at Day 35 by 10.5%, but not at Day 42. The KHCO3 caused a reduction in body weight, which was 13% less than the tap water group at Day 42, probably due to a chronic toxicity. The second trial specifically examined the same parameters with lower water levels of KHCO3 (3,000 and 1,000 mg/L), in comparison to a 10% feed restriction protocol, in order to clarify whether the increased PaO2 was due to a specific effect of the KHCO3 or was a metabolic manifestation of a reduced growth rate. The 3,000 mg/L KHCO3 treatment had no effect on PaO2, but the 1,000 mg/L treatment augmented PaO2 by 5.3% at Day 35 (but not at Days 28 or 42), without reducing the final body weight. The feed restriction group showed an elevated PaO2 of 5.4% at Day 35 (but not at Days 28 or 42), with no reduction in the final body weight. The inclusion of 1,000 mg/L of KHCO3 into the drinking water of broilers or a temporary 10% feed restriction may be means to augment PaO2.

Relationship between broiler chicken haematocrit-selected parents and their progeny, with regard to haematocrit, mortality from ascites and bodyweight

A previous work of this group demonstrated that the relative haematocrit value of broilers is inherited and may serve as an indicator to susceptibility to the ascites syndrome in cold-stressed broilers. In this study, a full-pedigreed population was produced from male and female grandparent breeding stock that was selected by haematocrit and by normal selection parameters. Matings were made between low (L), medium (M) and high (H) haematocrit parents: L x L, M x M, and H x H. In their progeny, both before and after cold exposure, there was a statistically linear relationship between actual haematocrit and their H, M and L grouping (P<0.0001); heritability of the haematocrit was high (0.46-0.81). Both the low haematocrit parent and progeny groups showed an increased bodyweight. Exposure of the progeny from all the parental groups to an ascites-predisposing cold environment caused similar losses from ascites in the progeny of all three groups. Although this finding was not the same as in the previous trial where the H haematocrit group was associated with high ascites mortality, it is hypothesized that other factors, such as arterial blood saturation with oxygen, interacted in these birds at genetic or environmental levels.

The infusion rate dependent influence of acute metabolic acidosis on pulmonary vascular resistance in broilers

Experiments were conducted to evaluate the pulmonary vascular responses of lightly anesthetized clinically healthy male broilers during acute metabolic acidosis induced by bolus i.v. injections or constant i.v. infusions of HCl. In Experiment 1, broilers received consecutive 1.5 mL i.v. bolus injections of 2.5% mannitol (volume control) and 0.4 N, 0.8 N, and 1.2 N HCl in 2.5% mannitol. Following each injection, equivalent concentrations of mannitol or HCl were infused i.v. at a rate of 0.05 mL/min.kg BW. In Experiment 2, repeated bolus injections of 2.5% mannitol and 1.2 N HCl were administered during ongoing constant infusion of 2.5% mannitol. The following variables were evaluated: pulmonary arterial pressure, pulmonary vascular resistance, mean arterial pressure, total peripheral resistance, cardiac output, stroke volume, heart rate, respiratory rate, hematocrit (HCT), and arterial blood gas (PaO2, PaCO2, pH, HCO3-). Mannitol alone did not alter any of the variables. The HCl loading protocols acidified the arterial blood to sustained (constant infusion) or transient (bolus injection) values averaging between pH 7.2 and 7.3. In both experiments, bolus injections of 1.2 N HCl caused transient increases in pulmonary vascular resistance and pulmonary arterial pressure, coincident with decreases in mean arterial pressure and cardiac output. When HCl was infused at a constant rate in Experiment 1, the arterial blood hydrogen ion concentration, [H+], was positively correlated with pulmonary arterial pressure and cardiac output, negatively correlated with mean arterial pressure and total peripheral resistance, and was not correlated with pulmonary vascular resistance. During constant i.v. infusion of mannitol or HCl in both experiments, pulmonary arterial pressure was positively correlated with pulmonary vascular resistance and cardiac output. Overall, bolus injections of 1.2 N HCl consistently triggered transient pulmonary vasoconstriction (increased pulmonary vascular resistance), leading to a transient increase in pulmonary arterial pressure in spite of opposing changes in cardiac output and mean arterial pressure. In contrast, equivalent or greater increases in [H+] during constant i.v. infusion of HCl caused a substantially lower increment in pulmonary arterial pressure, which, in, turn was primarily attributable to increases in cardiac output rather than pulmonary vascular resistance. Increments in either pulmonary vascular resistance or cardiac output induced by metabolic acidosis would be expected to contribute to the onset of pulmonary hypertension syndrome (PHS, ascites) in broilers.

Probabilistic neural network prediction of ascites in broilers based on minimally invasive physiological factors

A Probabilistic Neural Network (PNN) was trained to predict ascites in broilers based on minimally invasive inputs (i.e., physiological factors that do not require the death of the bird). A PNN is a supervised, three-layer, artificial neural network that classifies input patterns (e.g., physiological data) into specific output categories (e.g., ascites or no ascites). The PNN inputs were O2 level in the blood, body weight, electrocardiogram (ECG), hematocrit, S wave, and heart rate of individual birds. These data were from three experiments that have been described previously (Roush et al., 1996a,b). The three data sets were pooled into a combined data set for a total of 170 observations. From the pooled data, a training set (117 birds), a calibration set (17 birds), and a verification set (36 birds) were extracted. The PNN was trained on the training data set. To prevent the PNN from overfitting the training data, the neural network was evaluated on its ability to make correct predictions of the calibration data set. At the point at which the neural network made the highest number of correct classifications for the calibration data set, the trained neural network was saved on the computer. When the PNN was applied to the complete data set, the sensitivity or proportion of the birds with ascites that the PNN correctly diagnosed was 0.97 (75/77 birds). The specificity or proportion of birds that the PNN made a correct diagnosis of not having ascites was 0.98 (91/93 birds). When the PNN was applied to the verification data set, which was not subjected to neural network training, the sensitivity was 0.95 (19/20) and the specificity was 0.88 (14/16 birds). Use of models developed with artificial neural networks may enhance the diagnosis of ascites in broilers. The results may be useful in choosing and developing broiler strains that do not have a propensity for ascites.

The effect of strain of broiler on physiological parameters associated with the ascites syndrome

Differences among eight commercial broiler strains in factors indicating susceptibility to ascites were investigated. Chicks from eight crosses were obtained from two hatcheries (one was obtained from both hatcheries to give a total of nine) and raised to 6 wk of age on commercially prepared rations containing 3,300 kcal/kg energy with 24% protein to 3 wk of age and 20% protein from 3 to 6 wk. Each cross was represented by four pens of 90 broilers each. At 21 and 42 d, groups of 20 birds per pen were weighed and feed consumption was measured in order to calculate the feed conversion ratio. At 21 and 42 d, a blood sample was taken from two birds per pen to determine the hematocrit value. These birds were killed and dissected to determine heart, liver, lung, and spleen weights. Lung volume was determined by water displacement. Significant differences were observed between crosses for all of the measures with the exception of feed conversion ratio and mortality. These differences were most prominent for hematocrit value, which is an initial adaptation to anoxia, suggesting that broiler lines could be chosen that resist anoxic environmental conditions.

Artificial neural network prediction of ascites in broilers

An artificial neural network was trained to predict the presence or absence of ascites in broiler chickens. The neural network was a three-layer back-propagation neural network with an input layer of 15 neurons (defining 15 physiological variables), a hidden layer of 16 neurons, and an output layer of 2 neurons (the presence or absence of ascites). Male by-products of a breeder pullet line were brooded at 32 and 30 C during Weeks 1 and 2, respectively. The training set for the neural network consisted of data from birds subjected to cool temperatures (18 C) to induce ascites. After training, the predictive ability of the neural network was verified with two new data sets. The second data set was from birds subjected to cool temperatures (18 C). The third data set was from birds subjected to clamping of the pulmonary artery to simulate the physiological processes involved in ascites (the temperature was 24 C). A comparison was made between laboratory diagnostic results and the neural network predicted ascites incidence. The neural network accurately identified the presence or absence of ascites in the first (training) set. Two false positives and one false positive were identified in the second and third verification sets, respectively. The birds identified as false positives were determined to be in the developmental stages of ascites before the occurrence of fluid accumulation. Artificial neural networks were found to effectively identify broilers with and without ascites.

Cardio-pulmonary function during acute unilateral occlusion of the pulmonary artery in broilers fed diets containing normal or high levels of arginine-HCl

Cardio-pulmonary function was measured in male broilers reared on diets formulated to contain 1.5% arginine (NORMAL group) or 2.5% arginine (ARGININE group). A snare placed around the right pulmonary artery permitted acute shunting of the entire cardiac output (CO) through the left pulmonary artery, resulting in sustained increases in blood flow (BF) through the left lung in both groups. The unilateral increase in BF was accompanied by sustained increases in pulmonary arterial pressure (PAP) and pulmonary vascular resistance (PVR) in the NORMAL group. However, following initial transient increases in PAP and PVR in the ARGININE group, subsequent pulmonary vasodilation gradually reduced PVR, and thus PAP, in spite of the ongoing elevation of BF through the left lung. The capacity of the pulmonary vasculature in the ARGININE group to accommodate an increased BF at a normal PAP accounts for the previously reported lower incidence of pulmonary hypertension syndrome (PHS, ascites) in cold-stressed broilers fed supplemental dietary arginine. Hypoxemia and respiratory acidosis ensued rapidly in both groups after tightening the pulmonary artery snare, in spite of a compensatory increase in the respiratory rate. The gradual return of PVR and PAP to presnare levels in the ARGININE group did not eliminate the concurrent ventilation-perfusion mismatch caused by the increased rate of BF through the left lung. Tightening the pulmonary artery snare caused mean systemic arterial pressure (MAP) to drop from control levels of approximately 98 mm Hg to sustained hypotensive levels of approximately 65 mm Hg in both groups. This systemic hypotension was caused by decreases in CO and total peripheral resistance (TPR). The reduction in CO were caused by reduction in stroke volume (SV) rather than heart rate (HR), suggesting that acutely tightening the pulmonary artery snare increased PVR sufficiently to impede left ventricular filling. Accordingly, the maximum increment in PAP attainable by the right ventricle during acute increases in PVR apparently was inadequate to propel the entire CO through the pulmonary vasculature, setting the stage for the congestive right-sided pooling of blood routinely associated with PHS in broilers.

Electrocardiographic evaluation of broilers during the onset of pulmonary hypertension initiated by unilateral pulmonary artery occlusion

Electrocardiography previously has been used as a noninvasive method for detecting cardiac hypertrophy associated with pulmonary hypertension syndrome (PHS, ascites). In the present study, 36 of 100 male broiler chicks were selected for inclusion in the experiment based on their hatch weight (> or = 40 g), Day 1 to 14 BW gain (upper 50% of population distribution), and the normalcy of their Day 14 electrocardiogram (ECG). On day 16, 10 chicks were assigned to the unoperated control group (CONTROL), sham operations were performed on 10 chicks (SHAM), and pulmonary hypertension was initiated by clamping the left pulmonary artery in 16 chicks (PA-CLAMP). Electrocardiogram leads I, II, III, and aVF were recorded daily until Day 27, when 6 of the 12 birds surviving in the PA-CLAMP group had developed clinical ascites. The right: total ventricular weight ratio (RV:TV) was higher and BW was lower in the PA-CLAMP group than in the CONTROL and SHAM groups on Day 27. The RS, R, and S wave amplitudes in lead II for the CONTROL and SHAM groups did not change, whereas in lead II for the PA-CLAMP group the S wave attained a more negative amplitude by Day 21, the RS wave attained a more negative amplitude by Day 22, and the R wave declined to a less positive amplitude by Day 23 when compared with presurgery values. Similar differences were observed for the RS and S waves for leads III and aVF. The mean electrical axis (MEA) and mean resultant vector (MRV) of the CONTROL and SHAM groups did not change; however the PA-CLAMP group the MEA rotated significantly from +3 degrees to -72 degrees and to -88 degrees on Days 14, 22 and 27, respectively, and the MRV amplitude increased from 0.052 to 0.108 mV and then to 0.179 mV on Days 14, 22, and 27, respectively. When data from all treatment groups were combined, higher absolute and BW-normalized RV:TV ratios were inversely correlated (r = 0.859 to -0.880) with increasingly negative S wave amplitudes in leads II and aVF. Higher absolute and BW-normalized RV:TV ratios were directly correlated (r = 0.786 to 0.789) with increasing MRV amplitudes. These ECG characteristics constitute accurate, noninvasive predictive criteria suitable for detecting cardiac changes occurring early during the onset of primary pulmonary hypertension.

Effect of alpha-tocopherol on antioxidants, lipid peroxidation, and the incidence of pulmonary hypertension syndrome (ascites) in broilers

Research has demonstrated a compromised antioxidant capacity in broilers with pulmonary hypertension syndrome (PHS). Thus, the objective of the present study was to assess the effects of vitamin E on PHS-induced mortality, tissue antioxidants, and plasma lipid peroxides in male broilers. Control broilers were provided normal ventilation but others, maintained under low ventilation conditions to induce PHS, were randomly assigned to nonimplanted (NI), placebo (PL), or vitamin E (VE) implanted groups. The VE implant released a total of 15 mg of alpha-tocopherol from 0 to 3 wk of age. Tissues and blood samples were obtained at 3 and 5 wk of age from birds with (PHS+) and without (PHS-) PHS. Five-week PHS cumulative mortality was lowered by alpha-tocopherol with mortality rates of 3.6, 4.2, 11.9, and 11.8%, for Controls, VE, NI, and PL groups, respectively. The PHS+ birds exhibited lower body weights, higher hematocrit, right ventricular hypertrophy, lower alpha-tocopherol and glutathione (GSH) concentrations in liver and lung, as well as indicators of oxidative stress, including elevated plasma lipid peroxides and lower oxidized GSH in liver and erythrocytes, at 5 wk of age. All birds exhibited lower erythrocyte catalase activity at 5 than at 3 wk of age. An improved antioxidant capacity was observed in VE birds, including higher liver and lung alpha-tocopherol at 3 and 5 wk, higher liver GSH at 3 wk, and lower plasma lipid peroxide values at 5 wk of age. Direct correlations observed between body weight and plasma lipid peroxides at 3 wk (r = .45) and between right ventricular hypertrophy and plasma lipid peroxides at 5 wk (r = .48), suggests that lipid peroxidation plays a role in the etiology of PHS. The results indicate that the VE implant was effective in lowering PHS-induced mortality in broilers apparently by attenuating processes leading to lipid peroxidation.

Evidence of a ventilation-perfusion mismatch during acute unilateral pulmonary artery occlusion in broilers

A ventilation-perfusion (V/Q) mismatch can be diagnosed when a moderate increase in cardiac output (CO) causes systemic hypoxemia, thereby exposing a pulmonary incapacity to fully oxygenate the additional blood flowing through the pulmonary vasculature. The susceptibility of broiler chickens to hypoxemia was evaluated in lightly anesthetized, clinically healthy, 40- to 49-d-old males. A snare placed around one pulmonary artery permitted acute, reversible shunting of the entire CO through the unobstructed lung. Blood samples were withdrawn from arterial and venous cannulas for blood gas analysis, and a pulse oximeter was used for noninvasive measurements of the percentage saturation of hemoglobin with oxygen in arterialized capillary beds. The partial pressure of oxygen in arterial blood averaged 103 mm Hg during control periods, 79 mm Hg (hypoxemia) when the pulmonary artery snare was tightened for 12 min, and 101 mm Hg within 5 min after releasing the snare. The percentage saturation of hemoglobin with oxygen before, during, and after tightening the snare averaged, respectively, 96, 91, and 96% for arterial blood, 81, 55, and 78% for venous blood, and 87, 67, and 88% for arterialized capillary beds. Tightening the snare increased the partial pressure of carbon dioxide and the hydrogen ion concentration above control levels in both arterial and venous blood, and these variables returned to control levels upon release of the snare. The combined data constitute direct evidence that clinically healthy broiler chickens are susceptible to hypoxemia during an acute moderate (approximately twofold) increase in pulmonary blood flow.

A pulmonary artery clamp model for inducing pulmonary hypertension syndrome (ascites) in broilers

Two experiments were conducted to test the hypothesis that a primary increase in pulmonary vascular resistance can initiate a pathophysiological progression leading to pulmonary hypertension syndrome (PHS, ascites). Pulmonary vascular resistance was increased by surgically clamping the left pulmonary artery when male broiler chicks were 15 to 19 d of age, resulting in a 90% incidence of PHS in Experiment 1, and a 68% incidence of PHS in Experiment 2. The incidence of PHS was 8% for control or sham-operated broilers in Experiment 1, whereas in Experiment 2 no (0%) PHS occurred in sham-operated broilers or in individuals with a pulmonary artery that only was partially occluded. Broilers with a fully occluded left pulmonary artery developed pulmonary hypertension, as demonstrated by increased right:total ventricular weight ratios (right ventricular hypertrophy) and by increased electrocardiogram lead II R-S wave amplitudes (generalized ventricular dilation and hypertrophy). Forcing the entire cardiac output through the right lung resulted in a lower percentage saturation of hemoglobin with oxygen and an elevated hematocrit, reflecting generalized systemic hypoxemia. Pulmonary hypertension and hypoxemia also were specifically characteristic of all birds that developed ascites, regardless of treatment group. These observations demonstrate for the first time that PHS (ascites) can be directly induced by a primary increase in pulmonary vascular resistance. The observed changes in percentage saturation of hemoglobin with oxygen suggest that the lungs of broilers may be unable to efficiently oxygenate the blood when forced to receive an increased cardiac output at an elevated pulmonary arterial pressure.

Supplemental L-arginine attenuates pulmonary hypertension syndrome (ascites) in broilers

The incidence of pulmonary hypertension syndrome (PHS; ascites) was evaluated in two experiments using broiler breeder male by-product chicks exposed after 3 wk of age to cool environmental temperatures (10 to 15 C). In Experiment 1, 3- to 6-wk-old birds were fed a grower diet to which 0 (Control), .25, .5, or 1% supplemental L-arginine HCl had been added. During Weeks 7 to 8, all groups in Experiment 1 were fed a finisher diet containing no supplemental arginine. In Experiment 2, the Control group received no supplemental arginine, a second group was fed a grower diet supplemented with 1% L-arginine HCl (Weeks 3 to 6), and a third group was fed grower and finisher diets supplemented with 1% L-arginine HCl (Weeks 3 to 8). Cumulative PHS mortality was significantly reduced by 1% L-arginine HCl on Days 34 to 46 in Experiment 1. When data from all birds fed grower or finisher diets supplemented with 1% L-arginine HCl were pooled in Experiment 2, cumulative PHS mortality was marginally lower (P = .065) than for the Control group. Supplemental L-arginine HCl had no effect on final body weights, weight gain, or feed conversion in either experiment. Neither body weight on Day 1 or 21 nor net weight gain from Days 1 to 21 determined susceptibility to PHS during the subsequent grower and finisher intervals in either experiment.(ABSTRACT TRUNCATED AT 250 WORDS)