Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China.
Laboratory of Extracorporeal Life Support, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China.
Artif Organs. 2023 Jul;47(7):1163-1173. doi: 10.1111/aor.14499. Epub 2023 Jan 30.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been widely used in high-risk acute myocardial infarction (AMI) patients with promising outcomes. However, the underlying molecular mechanisms remain unknown and a VA-ECMO animal model has not yet been established. The purpose of this study was to establish a VA-ECMO model in AMI rats and evaluate long-term cardiac function.
We first established AMI in 20 Sprague-Dawley (SD) rats by ligating the left anterior descending coronary artery, while five rats underwent a thoracotomy to form the sham group. VA-ECMO was established after 30mins of AMI in 10 rats through the right jugular vein for venous drainage and right femoral artery for arterial infusion. Arterial blood pressure was monitored using a catheter in the left femoral artery, blood gas parameters were measured using a blood gas analyzer, while myocardial enzymes were detected using an ELISA Kit. Cardiac function was assessed through echocardiography on day 15. Masson staining and Western Blot were used for evaluating myocardial fibrosis, while histological injury was evaluated using hematoxylin and eosin staining.
VA-ECMO support stabilized blood pressure, decreased the levels of myocardial enzymes including cTnI, cTnT, CK-MB, and was associated with a higher survival rate. In the long term, the VA-ECMO group showed improved cardiac function, significantly increased EF and FS but significantly decreased EDV and ESV compared to the AMI group. Furthermore, VA-ECMO significantly alleviated pathological damage and myocardial fibrosis.
We established an economical, reliable, and reproducible VA-ECMO animal model in AMI rats, and demonstrated that VA-ECMO support prevents deteriorated cardiac function.
静脉-动脉体外膜肺氧合（VA-ECMO）已广泛应用于高危急性心肌梗死（AMI）患者，疗效确切。然而，其潜在的分子机制尚不清楚，也尚未建立 VA-ECMO 动物模型。本研究旨在建立 AMI 大鼠的 VA-ECMO 模型并评估其长期心功能。
通过结扎左前降支冠状动脉建立 20 只 Sprague-Dawley（SD）大鼠的 AMI 模型，其中 5 只大鼠行开胸术作为假手术组。在 AMI 后 30min 通过右侧颈内静脉进行静脉引流，右侧股动脉进行动脉输注，建立 10 只大鼠的 VA-ECMO。通过左股动脉内的导管监测动脉血压，血气分析仪测量血气参数，ELISA 试剂盒检测心肌酶。于第 15 天通过超声心动图评估心功能。采用 Masson 染色和 Western blot 评估心肌纤维化，苏木精和伊红染色评估组织学损伤。
VA-ECMO 支持稳定了血压，降低了心肌酶包括 cTnI、cTnT、CK-MB 的水平，与更高的存活率相关。长期来看，VA-ECMO 组的心功能明显改善，EF 和 FS 显著增加，但 EDV 和 ESV 显著降低，与 AMI 组相比差异有统计学意义。此外，VA-ECMO 显著减轻了病理损伤和心肌纤维化。
我们在 AMI 大鼠中建立了一种经济、可靠、可重复的 VA-ECMO 动物模型，证明了 VA-ECMO 支持可预防心功能恶化。
