超声心动图引导下经皮心肌内注射海藻酸钠水凝胶植入治疗心力衰竭：6个月随访的犬类模型
Echocardiography-guided percutaneous intramyocardial alginate hydrogel implants for heart failure: canine models with 6-month outcomes.
作者信息
Ma Hui, Gong Wenqing, Lim D Scott, Li Jing, Ta Shengjun, Hu Rui, Li Xiaojuan, Zheng Minjuan, Liu Liwen
机构信息
Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, United States.
出版信息
Front Cardiovasc Med. 2024 Jan 15;11:1320315. doi: 10.3389/fcvm.2024.1320315. eCollection 2024.
BACKGROUND
Echocardiography-guided percutaneous intramyocardial alginate-hydrogel implantation (PIMAHI) is a novel treatment approach for heart failure (HF). We validated PIMAHI safety and efficacy in canine HF models.
METHODS
Fourteen canines with HF [produced by coronary artery ligation, left ventricular ejection fraction (LVEF) < 35%] were randomised to PIMAHI treatment ( = 8) or controls ( = 6). Echocardiography, two-dimensional speckle tracking echocardiography, and pathological examinations after a 6-month follow-up were performed. Repeated-measures analysis of variance was used for within-group comparisons.
RESULTS
At 6-month follow-up, PIMAHI treatment reversed LV dilation and remodelling, increasing LV free wall thickness (LVFW, = 0.002) and interventricular septum thickness (IVS, < 0.001) and reducing LV end-diastolic volume (EDV, = 0.008) and end-systolic volume (ESV, = 0.004). PIMAHI significantly improved LV systolic function, increasing LVEF (EF, = 0.004); enhanced LV myocardial contractility, including increased LV global longitudinal strain (GLS, < 0.001), global circumferential strain (GCS, = 0.006), and mitral annulus displacement (MAD, = 0.001). Compared with controls at 6-month, PIMAHI group significantly increased LVFW thickness (8.5 ± 0.3 vs. 6.8 ± 0.2 mm, = 0.002) and IVS (7.9 ± 0.1 vs. 6.1 ± 0.2 mm, < 0.001); decreased LVEDV (30.1 ± 1.6 vs. 38.9 ± 4.5 ml, = 0.049) and ESV (17.3 ± 1.2 vs. 28.7 ± 3.6 ml, = 0.004); increased LV systolic function (42.7 ± 1.5 vs. 26.7 ± 1.1% in EF, = 0.001); and enhanced LV myocardial contractility including GLS (13.5 ± 0.8 vs. 8.4 ± 0.6%, = 0.002), GCS (16.5 ± 1.4 vs. 9.2 ± 0.6%, = 0.001), and MAD (11.4 ± 3.5vs 4.6 ± 2.5 mm, = 0.003). During PIMAHI treatment, no sustained arrhythmia, pericardial, or pleural effusion occurred.
CONCLUSIONS
PIMAHI in canine HF models was safe and effective. It reversed LV dilation and improved LV function.
背景
超声心动图引导下经皮心肌内海藻酸钠 - 水凝胶植入术（PIMAHI）是一种治疗心力衰竭（HF）的新型方法。我们在犬类HF模型中验证了PIMAHI的安全性和有效性。
方法
14只患有HF的犬（通过冠状动脉结扎产生，左心室射血分数[LVEF]<35%）被随机分为PIMAHI治疗组（n = 8）或对照组（n = 6）。在6个月的随访后进行了超声心动图、二维斑点追踪超声心动图和病理检查。采用重复测量方差分析进行组内比较。
结果
在6个月的随访中，PIMAHI治疗逆转了左心室扩张和重塑，增加了左心室游离壁厚度（LVFW，P = 0.002）和室间隔厚度（IVS，P<0.001），并减少了左心室舒张末期容积（EDV，P = 0.008）和收缩末期容积（ESV，P = 0.004）。PIMAHI显著改善了左心室收缩功能，增加了LVEF（EF，P = 0.004）；增强了左心室心肌收缩力，包括增加左心室整体纵向应变（GLS，P<0.001）、整体圆周应变（GCS，P = 0.006）和二尖瓣环位移（MAD，P = 0.001）。与6个月时的对照组相比，PIMAHI组显著增加了LVFW厚度（8.5±0.3 vs. 6.8±0.2 mm，P = 0.002）和IVS（7.9±0.1 vs. 6.1±0.2 mm，P<0.001）；降低了LVEDV（30.1±1.6 vs. 38.9±4.5 ml，P = 0.049）和ESV（17.3±1.2 vs. 28.7±3.6 ml，P = 0.004）；增加了左心室收缩功能（EF为42.7±1.5 vs. 26.7±1.1%，P = 0.001）；并增强了左心室心肌收缩力，包括GLS（13.5±0.8 vs. 8.4±0.6%，P = 0.002）、GCS（16.5±1.4 vs. 9.2±0.6%，P = 0.001）和MAD（11.4±3.5 vs 4.6±2.5 mm，P = 0.003）。在PIMAHI治疗期间，未发生持续性心律失常、心包积液或胸腔积液。
结论
犬类HF模型中的PIMAHI是安全有效的。它逆转了左心室扩张并改善了左心室功能。
Zotero 插件