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慢性缺血性心肌病啮齿动物模型中左心室几何形状的恢复及左心室功能的改善

Restoration of left ventricular geometry and improvement of left ventricular function in a rodent model of chronic ischemic cardiomyopathy.

作者信息

Yu Jiashing, Christman Karen L, Chin Eric, Sievers Richard E, Saeed Maythem, Lee Randall J

机构信息

University of California Berkeley and University of California San Francisco Joint Bioengineering Graduate Group, Berkeley/San Francisco, CA, USA.

出版信息

J Thorac Cardiovasc Surg. 2009 Jan;137(1):180-7. doi: 10.1016/j.jtcvs.2008.08.036.

Abstract

OBJECTIVES

Various approaches to myocardial reconstruction have been developed for the treatment of congestive heart failure resulting from ischemic cardiomyopathy.

METHODS

In this study we determined whether in situ application of polymers could reshape left ventricular geometry in a chronic rodent model of ischemic cardiomyopathy.

RESULTS

We demonstrate that alginate and fibrin can augment left ventricular wall thickness, resulting in reconstruction of left ventricular geometry and improvement of cardiac function. Echocardiographic results at 5 weeks after injection of alginate demonstrated persistent improvement of left ventricular fractional shortening and prevention of a continued enlargement of left ventricular dimensions, whereas fibrin glue demonstrated no progression of left ventricular negative remodeling. There was increased arteriogenesis in both the alginate and fibrin glue groups compared with that seen in the phosphate-buffered saline control group. Infarct size was significantly reduced in the fibrin group (P < .05), and there was a trend toward a smaller myocardial infarction in the alginate group.

CONCLUSION

Intramyocardially injected polymers can be used to reshape the aneurysmal left ventricle and might therefore be an approach for myocardial reconstruction and a potential option in treating chronic heart failure in human subjects.

摘要

目的

已开发出多种心肌重建方法用于治疗缺血性心肌病所致的充血性心力衰竭。

方法

在本研究中,我们确定了在慢性啮齿动物缺血性心肌病模型中,原位应用聚合物是否能重塑左心室几何形状。

结果

我们证明藻酸盐和纤维蛋白可增加左心室壁厚度,从而导致左心室几何形状的重建及心脏功能的改善。注射藻酸盐后5周的超声心动图结果显示,左心室缩短分数持续改善,且左心室尺寸持续增大得到预防,而纤维蛋白胶显示左心室负性重塑无进展。与磷酸盐缓冲盐水对照组相比,藻酸盐组和纤维蛋白胶组的血管生成均增加。纤维蛋白组的梗死面积显著减小(P < 0.05),藻酸盐组心肌梗死面积有减小趋势。

结论

心肌内注射聚合物可用于重塑左心室室壁瘤,因此可能是一种心肌重建方法,也是治疗人类慢性心力衰竭的潜在选择。

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