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尤卡坦小型猪经皮再灌注梗死重塑的多参数心脏磁共振成像

Multiparametric CMR imaging of infarct remodeling in a percutaneous reperfused Yucatan mini-pig model.

作者信息

Lopez David, Pan Jonathan A, Pollak Peter M, Clarke Samantha, Kramer Christopher M, Yeager Mark, Salerno Michael

机构信息

Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.

Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, VA, USA.

出版信息

NMR Biomed. 2017 May;30(5). doi: 10.1002/nbm.3693. Epub 2017 Feb 6.

Abstract

To further understanding of the temporal evolution and pathophysiology of adverse ventricular remodeling over the first 60 days following a myocardial infarction (MI) in both the infarcted and remote myocardium, we performed multi-parametric cardiac magnetic resonance (CMR) imaging in a closed-chest chronic Yucatan mini-pig model of reperfused MI. Ten animals underwent 90 min left anterior descending artery occlusion and reperfusion. Three animals served as controls. Multiparametric CMR (1.5T) was performed at baseline, Day 2, Day 30 and in four animals on Day 60 after MI. Left ventricular (LV) volumes and infarct size were measured. T and T mapping sequences were performed to measure values in the infarct and remote regions. Remote region collagen fractions were compared between infarcted animals and controls. Procedure success was 80%. The model created large infarcts (28 ± 5% of LV mass on Day 2), which led to significant adverse myocardial remodeling that stabilized beyond 30 days. Native T values did not reliably differentiate remote and infarct regions acutely. There was no evidence of remote fibrosis as indicated by partition coefficient and collagen fraction analyses. The infarct T values remained elevated up to 60 days after MI. Multiparametric CMR in this model showed significant adverse ventricular remodeling 30 days after MI similar to that seen in humans. In addition, this study demonstrated that remote fibrosis is absent and that infarct T signal remains chronically elevated in this model. These findings need to be considered when designing preclinical trials using CMR endpoints.

摘要

为了进一步了解心肌梗死(MI)后最初60天内心肌梗死和远隔心肌中不良心室重构的时间演变和病理生理学,我们在一个封闭胸腔的慢性尤卡坦小型猪再灌注MI模型中进行了多参数心脏磁共振(CMR)成像。十只动物接受了90分钟的左前降支动脉闭塞和再灌注。三只动物作为对照。在基线、第2天、第30天以及四只动物在MI后第60天进行了多参数CMR(1.5T)检查。测量了左心室(LV)容积和梗死面积。进行T和T映射序列以测量梗死区和远隔区的值。比较了梗死动物和对照之间远隔区的胶原分数。手术成功率为80%。该模型产生了大面积梗死(第2天占LV质量的28±5%),这导致了显著的不良心肌重构,在30天后趋于稳定。原生T值在急性期不能可靠地区分远隔区和梗死区。根据分配系数和胶原分数分析,没有远隔纤维化的证据。梗死区T值在MI后长达60天仍保持升高。该模型中的多参数CMR显示MI后30天有显著的不良心室重构,类似于在人类中观察到的情况。此外,本研究表明该模型中不存在远隔纤维化,且梗死区T信号长期升高。在设计使用CMR终点的临床前试验时需要考虑这些发现。

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