Kochupura Paul V, Azeloglu Evren U, Kelly Damon J, Doronin Sergey V, Badylak Stephen F, Krukenkamp Irvin B, Cohen Ira S, Gaudette Glenn R
Department of Surgery, Stony Brook University, Stony Brook, New York, USA.
Circulation. 2005 Aug 30;112(9 Suppl):I144-9. doi: 10.1161/CIRCULATIONAHA.104.524355.
Extracellular matrix (ECM), a tissue-engineered scaffold, recently demonstrated cardiomyocyte population after myocardial implantation. Surgical restoration of myocardium frequently uses Dacron as a myocardial patch. We hypothesized that an ECM-derived myocardial patch would provide a mechanical benefit not seen with Dacron.
Using a canine model, a full thickness defect in the right ventricle was repaired with either Dacron or ECM. A third group had no surgery and determined baseline RV function. Eight weeks later, global systolic function was assessed by the preload recruitable stroke work relationship. Regional systolic function was measured by systolic area contraction (SAC), calculated by high density mechanical mapping. Tau was used to assess global diastolic function. Recoil rate and diastolic shear were used as measures of regional diastolic function. After functional data acquisition, tissue was fixed for histological evaluation. Global systolic and diastolic functions were similar at baseline and after ECM and Dacron implantation. Regional systolic function was greater in the ECM group compared with the Dacron group (SAC: 4.1+/-0.9% versus -1.8+/-1.1, P<0.05). Regional diastolic function was also greater in the ECM group (recoil rate (degrees sec(-1)): -44+/-7 versus -17+/-2, ECM versus Dacron; P<0.05). Immunohistochemical analysis revealed cardiomyocytes in the ECM implant region, a finding not seen with Dacron.
At 8 weeks, an ECM-derived tissue-engineered myocardial patch provides regional mechanical function, likely related to cardiomyocyte population. These results are in sharp contrast to Dacron, a commonly used myocardial patch.
细胞外基质（ECM）作为一种组织工程支架，最近在心肌植入后显示出有心肌细胞聚集。心肌的外科修复经常使用涤纶作为心肌补片。我们推测，源自ECM的心肌补片将提供涤纶所没有的机械优势。
使用犬类模型，用涤纶或ECM修复右心室全层缺损。第三组不进行手术，作为右心室功能的基线对照。8周后，通过前负荷可募集搏功关系评估整体收缩功能。通过收缩期面积收缩（SAC）测量局部收缩功能，SAC通过高密度机械标测计算得出。用Tau评估整体舒张功能。回弹率和舒张期剪切力用作局部舒张功能的指标。获取功能数据后，将组织固定用于组织学评估。在基线以及植入ECM和涤纶后，整体收缩和舒张功能相似。与涤纶组相比，ECM组的局部收缩功能更强（SAC：4.1±0.9% 对 -1.8±1.1，P<0.05）。ECM组的局部舒张功能也更强（回弹率（度·秒⁻¹）：-44±7对 -17±2，ECM对涤纶；P<0.05）。免疫组织化学分析显示ECM植入区域有心肌细胞，涤纶组未见此现象。
在8周时，源自ECM的组织工程心肌补片提供局部机械功能，可能与心肌细胞聚集有关。这些结果与常用的心肌补片涤纶形成鲜明对比。
