Sabbah H N, Stein P D, Kono T, Gheorghiade M, Levine T B, Jafri S, Hawkins E T, Goldstein S
Henry Ford Heart and Vascular Institute, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan 48202.
Am J Physiol. 1991 Apr;260(4 Pt 2):H1379-84. doi: 10.1152/ajpheart.1991.260.4.H1379.
A canine model of chronic heart failure was produced by multiple sequential intracoronary embolizations with microspheres. Twenty closed-chest dogs underwent three to nine intracoronary embolizations performed 1-3 wk apart. Embolizations were discontinued when left ventricular (LV) ejection fraction was less than 35%. LV ejection fraction was 64 +/- 2% at baseline and decreased to 21 +/- 1% at 3 mo after the last embolization (P less than 0.001). During the same period, LV end-diastolic pressure increased from 6 +/- 1 to 22 +/- 3 mmHg (P less than 0.001); LV end-diastolic volume increased from 64 +/- 3 to 101 +/- 6 6 ml (P less than 0.001), and cardiac output decreased from 2.9 +/- 0.2 to 2.3 +/- 0.1 l/min (P less than 0.01). These changes were accompanied by significant increases of pulmonary artery wedge pressure and systemic vascular resistance. Plasma norepinephrine increased from 332 +/- 17 pg/ml at baseline to 791 +/- 131 pg/ml at 3 mo after the last embolization (P less than 0.01); plasma levels of atrial natriuretic factor increased from 12.7 +/- 10.0 to 28.8 +/- 8.6 pmol/l (P less than 0.01), whereas plasma renin activity remained unchanged. Gross and microscopic postmortem examination showed patchy myocardial fibrosis and LV hypertrophy. We conclude that multiple intracoronary embolizations with microspheres, separated in time, can lead to chronic heart failure in dogs. The preparation is stable and reproducible and manifests many of the sequelae of heart failure that result from loss of contractile myocardium.
通过多次连续冠状动脉内微球栓塞制作犬慢性心力衰竭模型。20只开胸犬接受了3至9次冠状动脉内栓塞,每次栓塞间隔1 - 3周。当左心室射血分数低于35%时停止栓塞。基线时左心室射血分数为64±2%,最后一次栓塞后3个月降至21±1%(P<0.001)。同期,左心室舒张末期压力从6±1 mmHg升至22±3 mmHg(P<0.001);左心室舒张末期容积从64±3 ml增至101±6 ml(P<0.001),心输出量从2.9±0.2 l/min降至2.3±0.1 l/min(P<0.01)。这些变化伴随着肺动脉楔压和全身血管阻力的显著增加。血浆去甲肾上腺素从基线时的332±17 pg/ml增至最后一次栓塞后3个月的791±131 pg/ml(P<0.01);血浆心房利钠因子水平从12.7±10.0 pmol/l增至28.8±8.6 pmol/l(P<0.01),而血浆肾素活性保持不变。大体和显微镜下尸检显示心肌有散在纤维化和左心室肥厚。我们得出结论,多次时间间隔的冠状动脉内微球栓塞可导致犬慢性心力衰竭。该模型稳定且可重复,表现出许多因收缩性心肌丧失导致的心力衰竭后遗症。