Ishihara K, Zile M R, Tomita M, Tanaka R, Kanazawa S, Carabello B A
Department of Medicine, Medical University of South Carolina, Charleston 29425-2221.
Cardiovasc Res. 1992 Jun;26(6):580-5. doi: 10.1093/cvr/26.6.580.
The goal of therapy for left ventricular pressure overload should include regression of the associated left ventricular hypertrophy, but this process is incompletely understood. The aim of the study was to characterise the extent and time course of the progression and regression of pressure overload left ventricular hypertrophy in a canine hypertrophy model.
Six puppies were studied longitudinally with haemodynamic and echocardiographic measurements for 10 months. The study animals underwent ascending aortic banding at nine weeks of age which produced an initial gradient of 30 mm Hg. Subsequent growth led to an increase in gradient and the development of left ventricular hypertrophy. Then thoracotomy was again performed to remove the band. One month later, balloon aortoplasty was performed to remove the residual gradient. The animals were then observed for six months.
Growth increased the gradient to 105(SEM 10) mm Hg three months after banding. The left ventricular weight to body weight ratio (g.kg-1), an index of hypertrophy, was 7.2(0.5) after three months of pressure overload. Subsequently the band was surgically removed, reducing the gradient to an average of 58(10) mm Hg. Balloon dilatation of the residual aortic stricture reduced the gradient further to 6(5) mm Hg. Over the ensuing six months, echocardiographic determination of left ventricular mass showed the regression in left ventricular hypertrophy. After six months, left ventricular weight to body weight ratio in the previously banded animals was significantly reduced from 7.2(0.5) to 5.3(0.2) (p less than 0.05).
The model produced over 100% left ventricular hypertrophy, most of which regressed following removal of the pressure overload.
左心室压力超负荷的治疗目标应包括使相关的左心室肥厚消退,但这一过程尚未完全明确。本研究的目的是在犬类肥厚模型中描述压力超负荷性左心室肥厚进展和消退的程度及时间进程。
对6只幼犬进行了为期10个月的血流动力学和超声心动图纵向研究。研究动物在9周龄时进行升主动脉缩窄,产生初始压力阶差30 mmHg。随后的生长导致压力阶差增加和左心室肥厚的发展。然后再次开胸移除缩窄带。1个月后,进行球囊主动脉成形术以消除残余压力阶差。然后对动物观察6个月。
缩窄后3个月,生长使压力阶差增加到105(标准误10)mmHg。压力超负荷3个月后,左心室重量与体重比(g.kg-1),即肥厚指数,为7.2(0.5)。随后手术移除缩窄带,使压力阶差平均降至58(10)mmHg。对残余主动脉狭窄进行球囊扩张使压力阶差进一步降至6(5)mmHg。在随后的6个月中,超声心动图测定左心室质量显示左心室肥厚消退。6个月后,先前缩窄的动物的左心室重量与体重比从7.2(0.5)显著降至5.3(0.2)(p<0.05)。
该模型产生了超过100%的左心室肥厚,其中大部分在压力超负荷解除后消退。