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The relative contribution of RV microvascular rarefaction vs reduced right coronary artery perfusion pressure (RCA\u2010PP) to RV ischemia remains unknown. We hypothesize that increasing RCA\u2010PP improves RV function in PAH by increasing RV systolic perfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Supra\u2010coronary aortic banding (SAB) or sham surgery was performed on male Sprague\u2010Dawley rats. Seven to ten days later, rats received either monocrotaline (MCT; 60\u00a0mg\/kg) or saline. After 1\u00a0month, echocardiography, cardiac catheterization, <jats:sup>99m<\/jats:sup>Tc\u2010sestamibi single\u2010photon emission computed tomography (SPECT) and microsphere infusion studies were performed. The RV was harvested for measurement of hypertrophy (RVH), fibrosis and immunoblotting, and the lung was harvested for pulmonary artery (PA) histology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Supra\u2010coronary aortic banding increased systolic pressures in proximal aorta and systolic RCA\u2010PP in SAB\u00a0+\u00a0MCT vs MCT rats (114\u00a0\u00b1\u00a012 vs 5\u00a0\u00b1\u00a09\u00a0mm\u00a0Hg), without altering diastolic RCA\u2010PP. SAB\u00a0+\u00a0MCT rats had improved RV function vs MCT rats, evident from their significantly increased cardiac output (CO), RV free wall (RVFW) thickening, tricuspid annular plane systolic excursion (TAPSE) and RV\u2010PA coupling indices. RV\u2010PA coupling indices and CO correlated directly with systolic RCA\u2010PP. RV perfusion was increased in SAB\u00a0+\u00a0MCT vs MCT rats and correlated well with CO; whereas microvascular rarefaction was unaltered. SAB\u00a0+\u00a0MCT rats had less RVH and fibrosis and lower PA pressures vs MCT rats. SAB\u00a0+\u00a0MCT rats had significantly lower RV pyruvate kinase muscle isoform 2\/1 ratios than MCT rats, consistent with restoration of oxidative metabolism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A SAB\u2010induced increase in systolic RCA\u2010PP improves RV perfusion and function in MCT rats. Maintaining systolic RCA perfusion can preserve RV function in PAH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apha.13483","type":"journal-article","created":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T20:33:11Z","timestamp":1588019591000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Supra\u2010coronary aortic banding improves right ventricular function in experimental pulmonary arterial hypertension in rats by increasing systolic right coronary artery perfusion"],"prefix":"10.1111","volume":"229","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9699-8009","authenticated-orcid":false,"given":"Lian","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Medicine Queen's University Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping Yu","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen's University Kingston ON Canada"},{"name":"Department of Biomedical and Molecular Sciences Queen's University Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elahe","family":"Alizadeh","sequence":"additional","affiliation":[{"name":"Queen's CardioPulmonary Unit (QCPU) Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia D. 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