Katsanos Konstantinos, Mitsos Sofoklis, Koletsis Efstratios, Bravou Vassiliki, Karnabatidis Dimitris, Kolonitsiou Fevronia, Diamantopoulos Athanassios, Dougenis Dimitrios, Siablis Dimitris
Department of Interventional Radiology, Patras University Hospital, School of Medicine, 26504, Rion, Greece.
J Cardiothorac Surg. 2012 Feb 13;7:16. doi: 10.1186/1749-8090-7-16.
To date, most animal studies of myocardial ischemia have used open-chest models with direct surgical coronary artery ligation. We aimed to develop a novel, percutaneous, minimally-invasive, closed-chest model of experimental myocardial infarction (EMI) in the New Zealand White rabbit and compare it with the standard open-chest surgical model in order to minimize local and systemic side-effects of major surgery.
New Zealand White rabbits were handled in conformity with the "Guide for the Care and Use of Laboratory Animals" and underwent EMI under intravenous anesthesia. Group A underwent EMI with an open-chest method involving surgical tracheostomy, a mini median sternotomy incision and left anterior descending (LAD) coronary artery ligation with a plain suture, whereas Group B underwent EMI with a closed-chest method involving fluoroscopy-guided percutaneous transauricular intra-arterial access, superselective LAD catheterization and distal coronary embolization with a micro-coil. Electrocardiography (ECG), cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP) measurements were recorded. Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining.
In total, 38 subjects underwent EMI with a surgical (n = 17) or endovascular (n = 21) approach. ST-segment elevation (1.90 ± 0.71 mm) occurred sharply after surgical LAD ligation compared to progressive ST elevation (2.01 ± 0.84 mm;p = 0.68) within 15-20 min after LAD micro-coil embolization. Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05). Infarct area was similar in both models (0.86 ± 0.35 cm in the surgical group vs. 0.92 ± 0.54 cm in the percutaneous group;p = 0.68).
The proposed model of transauricular coronary coil embolization avoids thoracotomy and major surgery and may be an equally reliable and reproducible platform for the experimental study of myocardial ischemia.
迄今为止，大多数心肌缺血的动物研究都采用开胸模型，直接进行外科冠状动脉结扎。我们旨在开发一种新型的、经皮的、微创的新西兰白兔实验性心肌梗死（EMI）闭胸模型，并将其与标准的开胸手术模型进行比较，以尽量减少大手术的局部和全身副作用。
新西兰白兔按照《实验动物饲养与使用指南》进行处理，并在静脉麻醉下接受EMI。A组采用开胸方法进行EMI，包括手术气管切开、小正中胸骨切开术切口以及用普通缝线结扎左前降支（LAD）冠状动脉，而B组采用闭胸方法进行EMI，包括透视引导下经耳动脉动脉内穿刺、LAD超选择性插管以及用微线圈进行冠状动脉远端栓塞。记录心电图（ECG）、心肌酶和经导管左心室舒张末期压力（LVEDP）测量值。存活的动物在4周后实施安乐死，并取出心脏进行苏木精-伊红和Masson三色染色。
总共有38只受试动物采用手术（n = 17）或血管内（n = 21）方法进行了EMI。与LAD微线圈栓塞后15 - 20分钟内逐渐出现的ST段抬高（2.01±0.84 mm；p = 0.68）相比，手术结扎LAD后ST段急剧抬高（1.90±0.71 mm）。两组均记录到肌钙蛋白和其他心肌酶升高、异常缺血性Q波以及LVEDP变化，且无任何显著差异（p > 0.05）。两种模型的梗死面积相似（手术组为0.86±0.35 cm，经皮组为0.92±0.54 cm；p = 0.68）。
所提出的经耳冠状动脉线圈栓塞模型避免了开胸和大手术，可能是心肌缺血实验研究同样可靠且可重复的平台。
