Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
National Center for Structural Biology and Bioimaging, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Front Cell Infect Microbiol. 2019 Sep 24;9:332. doi: 10.3389/fcimb.2019.00332. eCollection 2019.
The failure to translate preclinical results to the clinical setting is the rule, not the exception. One reason that is frequently overlooked is whether the animal model reproduces distinctive features of human disease. Another is the reproducibility of the method used to measure treatment effects in preclinical studies. Left ventricular (LV) function improvement is the most common endpoint in preclinical cardiovascular disease studies, while echocardiography is the most frequently used method to evaluate LV function. In this work, we conducted a robust echocardiographic evaluation of LV size and function in dogs chronically infected by . Echocardiography was performed blindly by two distinct observers in mongrel dogs before and between 6 and 9 months post infection. Parameters analyzed included end-systolic volume (ESV), end-diastolic volume (EDV), ejection fraction (EF), and fractional shortening (FS). We observed a significant LVEF and FS reduction in infected animals compared to controls, with no significant variation in volumes. However, the effect of chronic infection in systolic function was quite variable, with EF ranging from 17 to 66%. Using the cut-off value of EF ≤ 40%, established for dilated cardiomyopathy (DCM) in dogs, only 28% of the infected dogs were affected by the chronic infection. The canine model of CCC mimics human disease, reproducing the percentage of individuals that develop heart failure during the chronic infection. It is thus mandatory to establish inclusion criteria in the experimental design of canine preclinical studies to account for the variable effect that chronic infection has on systolic function.
临床前研究结果未能转化为临床应用是普遍现象。其中一个常被忽视的原因是动物模型是否能再现人类疾病的独特特征。另一个原因是用于测量临床前研究中治疗效果的方法的可重复性。左心室(LV)功能改善是临床前心血管疾病研究中最常见的终点,而超声心动图是评估 LV 功能最常用的方法。在这项工作中,我们对慢性感染的犬进行了稳健的超声心动图评估。在感染前后 6 至 9 个月,由两名不同的观察者对杂种犬进行了超声心动图检查。分析的参数包括收缩末期容积(ESV)、舒张末期容积(EDV)、射血分数(EF)和缩短分数(FS)。与对照组相比,感染动物的 LVEF 和 FS 明显降低,而容积没有明显变化。然而,慢性感染对收缩功能的影响差异很大,EF 范围从 17%到 66%。使用 EF≤40%的截断值,该值适用于犬扩张型心肌病(DCM),只有 28%的感染犬受到慢性感染的影响。CCC 的犬模型模拟人类疾病,再现了在慢性感染过程中发展为心力衰竭的个体比例。因此,在犬科临床前研究的实验设计中,必须建立纳入标准,以说明慢性感染对收缩功能的可变影响。