Hála Pavel, Mlček Mikuláš, Ošťádal Petr, Janák David, Popková Michaela, Bouček Tomáš, Lacko Stanislav, Kudlička Jaroslav, Neužil Petr, Kittnar Otomar
Department of Physiology, First Faculty of Medicine, Charles University; Department of Cardiology, Na Homolce Hospital;
Department of Physiology, First Faculty of Medicine, Charles University.
J Vis Exp. 2018 Feb 17(132):57030. doi: 10.3791/57030.
A stable and reliable model of chronic heart failure is required for many experiments to understand hemodynamics or to test effects of new treatment methods. Here, we present such a model by tachycardia-induced cardiomyopathy, which can be produced by rapid cardiac pacing in swine. A single pacing lead is introduced transvenously into fully anaesthetized healthy swine, to the apex of the right ventricle, and fixated. Its other end is then tunneled dorsally to the paravertebral region. There, it is connected to an in-house modified heart pacemaker unit that is then implanted in a subcutaneous pocket. After 4 - 8 weeks of rapid ventricular pacing at rates of 200 - 240 beats/min, physical examination revealed signs of severe heart failure - tachypnea, spontaneous sinus tachycardia, and fatigue. Echocardiography and X-ray showed dilation of all heart chambers, effusions, and severe systolic dysfunction. These findings correspond well to decompensated dilated cardiomyopathy and are also preserved after the cessation of pacing. This model of tachycardia-induced cardiomyopathy can be used for studying the pathophysiology of progressive chronic heart failure, especially hemodynamic changes caused by new treatment modalities like mechanical circulatory supports. This methodology is easy to perform and the results are robust and reproducible.
许多实验需要一个稳定可靠的慢性心力衰竭模型来了解血流动力学或测试新治疗方法的效果。在此,我们通过心动过速诱导的心肌病提出这样一个模型,该模型可通过对猪进行快速心脏起搏产生。将一根起搏导线经静脉引入完全麻醉的健康猪体内,到达右心室心尖并固定。然后将其另一端经背部隧道引至椎旁区域。在那里,它与一个内部改良的心脏起搏器单元相连,然后将该起搏器单元植入皮下囊袋。以200 - 240次/分钟的速率进行4 - 8周的快速心室起搏后,体格检查显示出严重心力衰竭的体征——呼吸急促、自发性窦性心动过速和疲劳。超声心动图和X线显示所有心腔扩大、积液和严重的收缩功能障碍。这些发现与失代偿性扩张型心肌病非常吻合,并且在起搏停止后仍然存在。这种心动过速诱导的心肌病模型可用于研究进行性慢性心力衰竭的病理生理学,特别是由机械循环支持等新治疗方式引起的血流动力学变化。该方法易于实施,结果可靠且可重复。