Orgil Buyan-Ochir, Chintanaphol Michelle, Alberson Neely R, Letourneau Lea, Martinez Hugo R, Towbin Jeffrey A, Purevjav Enkhsaikhan
The Heart Institute, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA.
Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN 38103, USA.
Rev Cardiovasc Med. 2024 Sep 29;25(10):351. doi: 10.31083/j.rcm2510351. eCollection 2024 Oct.
Heart failure is a clinical syndrome that has become a leading public health problem worldwide. Globally, nearly 64 million individuals are currently affected by heart failure, causing considerable medical, financial, and social challenges. One therapeutic option for patients with advanced heart failure is mechanical circulatory support (MCS) which is widely used for short-term or long-term management. MCS with various ventricular assist devices (VADs) has gained traction in end-stage heart failure treatment as a bridge-to-recovery, -decision, -transplant or -destination therapy. Due to limitations in studying VADs in humans, animal studies have substantially contributed to the development and advancement of MCS devices. Large animals have provided an avenue for developing and testing new VADs and improving surgical strategies for VAD implantation and for evaluating the effects and complications of MCS on hemodynamics and organ function. VAD modeling by utilizing rodents and small animals has been successfully implemented for investigating molecular mechanisms of cardiac unloading after the implantation of MCS. This review will cover the animal research that has resulted in significant advances in the development of MCS devices and the therapeutic care of advanced heart failure.
心力衰竭是一种临床综合征,已成为全球主要的公共卫生问题。在全球范围内,目前近6400万人受到心力衰竭的影响,带来了巨大的医疗、经济和社会挑战。对于晚期心力衰竭患者,一种治疗选择是机械循环支持(MCS),它被广泛用于短期或长期治疗。带有各种心室辅助装置(VAD)的MCS作为过渡到康复、决策、移植或终末治疗,在终末期心力衰竭治疗中受到关注。由于在人体中研究VAD存在局限性,动物研究对MCS装置的开发和进步做出了重大贡献。大型动物为开发和测试新的VAD、改进VAD植入的手术策略以及评估MCS对血流动力学和器官功能的影响及并发症提供了途径。利用啮齿动物和小型动物进行VAD建模已成功用于研究MCS植入后心脏卸载的分子机制。本综述将涵盖在MCS装置开发和晚期心力衰竭治疗护理方面取得重大进展的动物研究。