Magnetic resonance imaging assessment of cardiac function in a swine model of hibernating myocardium 3 months following bypass surgery.
Magnetic resonance imaging assessment of cardiac function in a swine model of hibernating myocardium 3 months following bypass surgery.
复制标题
磁共振成像评估搭桥手术后 3 个月冬眠心肌猪模型的心脏功能。
DOI：
10.1016/j.jtcvs.2016.10.089
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kelly,RosemaryF
中科院分区：
文献类型：
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作者：
HocumStone,LauraL;Swingen,Cory;Holley,Christopher;Wright,Christin;Chappuis,Erin;Ward,HerbertB;McFalls,EdwardO;Kelly,RosemaryF
临床研究表明冠状动脉旁路移植术（CABG）后冬眠心肌（HM）恢复延迟。心脏磁共振（CMR）成像是有效的识别HM在临床设置。我们的HM动物模型在CABG后1个月使用超声心动图显示部分但不完全的功能恢复。本研究使用CMR成像，以确定恢复3个月后，CABG.MethodsSwine（N = 12）的完整性进行了左前降支动脉（LAD）1.5厘米缩窄器的位置，创造一个领土HM超过12周。12周时的CMR证实了无梗死的冬眠（N = 12）。在9只动物中进行了非体外循环左胸廓内动脉（LITA）至LAD的手术。处死3只动物作为HM对照。在1个月（n = 4）或3个月（n = 5）死亡前，在血管重建动物中重复CMR成像。CMR成像进行了基线和多巴酚丁胺输液（5 μg/kg/min）。Results 12周后缩窄器的位置，CMR成像证实了所有动物的生存能力在LAD区域和LAD狭窄。在HM中，室壁增厚在基线时减少，但在多巴酚丁胺输注期间存在收缩储备。血运重建后，CMR成像证实LITA移植物通畅（n = 9）。基线区域功能的分析表明，不完全恢复HM CABG后，减少收缩储备在1和3个月post-CABG.ConclusionsCMR成像提供了准确的空间分辨率区域收缩功能，并确认HM的存在下，在12周后仪器的LAD。CABG术后3个月，单个LAD区域HM部分恢复，具有收缩储备。
ObjectiveClinical studies demonstrate delayed recovery of hibernating myocardium (HM) following coronary artery bypass graft (CABG) surgery. Cardiac magnetic resonance (CMR) imaging is effective in identifying HM in clinical settings. Our animal model of HM shows partial but incomplete functional recovery 1 month following CABG using echocardiography. This study uses CMR imaging to determine completeness of recovery 3 months post-CABG.MethodsSwine (N = 12) underwent left anterior descending artery (LAD) 1.5-cm constrictor placement creating a territory of HM over 12 weeks. CMR at 12 weeks confirmed hibernation without infarction (N = 12). Off-pump left internal thoracic artery (LITA) to the LAD was performed in 9 animals. Three animals were killed as HM controls. CMR imaging was repeated in revascularized animals before death at 1 (n = 4) or 3 months (n = 5). CMR imaging was performed at baseline and with dobutamine infusion (5 μg/kg/min).ResultsTwelve weeks after constrictor placement, CMR imaging confirmed viability in LAD region and LAD stenosis in all animals. In HM, wall thickening is reduced at baseline but with contractile reserve present during dobutamine infusion. Following revascularization, CMR imaging confirmed patent LITA graft (n = 9). Analysis of baseline regional function shows incomplete recovery of HM following CABG, with reduced contractile reserve at both 1 and 3 months post-CABG.ConclusionsCMR imaging provides accurate spatial resolution of regional contractile function and confirms the presence of HM at 12 weeks following instrumentation of the LAD. Three months following CABG, partial recovery of HM with contractile reserve is present in the single LAD territory.