Vaynblat M, Chiavarelli M, Shah H R, Ramdev G, Aron M, Zisbrod Z, Cunningham J N
Division of Cardiothoracic Surgery, State University of New York-Health Science Center at Brooklyn 11203, USA.
Ann Thorac Surg. 1997 Jul;64(1):81-5. doi: 10.1016/s0003-4975(97)00349-4.
Cardiomyoplasty is a potential therapy for heart failure. Its benefits are attributed to systolic augmentation (dynamic cardiomyoplasty) and prevention of cardiac dilatation (static cardiomyoplasty). To evaluate the static component, we used an artificial membrane for cardiac binding in a canine model of heart failure.
Intracoronary doxorubicin was administered weekly for 4 weeks to induce heart failure in 10 dogs, each of which was assigned to one of two treatment groups: (1) no treatment, or (2) cardiac binding. Hemodynamic data were obtained at operation and at 7 weeks after operation. Echocardiography was performed weekly.
Left ventricular end-diastolic pressure and diameter, and right ventricular end-diastolic diameter increased in group 1 (from 9.6 +/- 6.1 to 19.6 +/- 2.3 mm Hg, p = 0.009; from 3.9 +/- 0.4 to 5 +/- 0.3 cm, p = 0.0013; and from 1.6 +/- 0.2 to 1.9 +/- 0.3 cm, p = 0.0036, respectively). Ejection fraction fell in group 1 from 0.60 +/- 0.10 to 0.40 +/- 0.04 (p = 0.0009) and in group 2 from 0.56 +/- 0.02 to 0.40 +/- 0.04 (p = 0.0001), but the difference between groups was not significant.
Cardiac binding reduces the ventricular dilatation associated with heart failure without exacerbating left ventricular dysfunction.
心肌成形术是心力衰竭的一种潜在治疗方法。其益处归因于收缩期增强（动态心肌成形术）和预防心脏扩张（静态心肌成形术）。为了评估静态成分，我们在犬类心力衰竭模型中使用人工膜进行心脏固定。
10只犬每周接受一次冠状动脉内阿霉素注射，共4周以诱导心力衰竭，每只犬被分配到两个治疗组之一：（1）不治疗，或（2）心脏固定。在手术时和术后7周获取血流动力学数据。每周进行超声心动图检查。
第1组左心室舒张末期压力和直径以及右心室舒张末期直径增加（分别从9.6±6.1至19.6±2.3 mmHg，p = 0.009；从3.9±0.4至5±0.3 cm，p = 0.0013；从1.6±0.2至1.9±0.3 cm，p = 0.0036）。第1组射血分数从0.60±0.10降至0.40±0.04（p = 0.0009），第2组从0.56±0.02降至0.40±0.04（p = 0.0001），但两组之间差异不显著。
心脏固定可减少与心力衰竭相关的心室扩张，而不会加重左心室功能障碍。
