Attenuation of Left Ventricular Adverse Remodeling With Epicardial Patching After Myocardial Infarction
Attenuation of Left Ventricular Adverse Remodeling With Epicardial Patching After Myocardial Infarction
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DOI：
10.1016/j.cardfail.2010.02.007
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发表时间：
2010-07-01
影响因子：
6
通讯作者：
Tse, Hung-Fat
中科院分区：
文献类型：
--
作者：
Liao, Song-Yan;Siu, Chung-Wah;Tse, Hung-Fat
背景：先前的研究表明，在急性心肌梗死（MI）后将心外膜补片应用于梗死部位可减轻左心室（LV）重构并改善心脏功能；然而，局部心外膜补片对左心室重构慢性期的影响仍不清楚。
方法和结果：我们研究了20只因远端栓塞导致心肌梗死且左室射血分数受损（LVEF<40%）的猪。将其随机分为两组（每组n = 10）：补片组在梗死部位应用一种简单的、被动的合成心外膜补片；对照组仅接受假手术。在8周和20周时，通过心脏磁共振成像（MRI）评估心脏功能和结构。在8周时，两组的LV舒张末期容积（LVEDV）、LV收缩末期容积（LVESV）和LVEF无显著差异（P>0.05）。通过心脏MRI测定，与8周时相比，两组在20周时的LV舒张末期容积和LV收缩末期容积均增加（P<0.05）。然而，与补片组相比，对照组的LV舒张末期容积增加（+14.1±1.8%对+6.6±2.1%，P = 0.015）和LV收缩末期容积增加（+12.1±2.4%对4.7±3.7%，P = 0.0015）更为显著。此外，从8周至20周，补片组的LVEF百分比增加（+17.3±4.9%对+4.1±3.9%，P = 0.048）较对照组更为显著。组织学检查显示，与对照组相比，补片组梗死区域及相邻的梗死周边区域的LV壁厚度显著增加（P<0.05）。
结论：在大型心肌梗死动物模型中，局部应用一种简单的、被动的合成心外膜补片可增加梗死区域的LV壁厚度，减轻LV扩张，并改善LVEF和 +dP/dt。（《心力衰竭杂志》2010年；16：590 - 598）
Background: Previous studies suggested that epicardial patch applied to the infarcted site after acute myocardial infarction (MI) can alleviate left ventricular (LV) remodeling and improve cardiac performance; however, the effects of regional epicardial patch on chronic phase of LV remodeling remain unclear.Methods and Results: We studied 20 pigs with MI induced by distal embolization and impaired LVejection fraction (LVEF .05). As determined by cardiac MRI, LV end-diastolic and end-systolic volumes increased at 20 weeks compared with 8 weeks in both groups (P < .05). However, the increase in LV end-diastolic volume (+14.1 +/- 1.8% vs. +6.6 +/- 2.1%, P = .015) and LV end-systolic volume (+12.1 +/- 2.4% vs. 4.7 +/- 3.7%, P = .0015) were significantly greater in the control group compared with the patch group. Furthermore, the percentage increase in LVEF (+17.3 +/- 4.9% vs. +4.1 +/- 3.9%, P = .048) from 8 to 20 weeks was significantly greater in the patch group compared with the control group. Histological examination showed that LV wall thickness at the infarct region and adjacent pen-infarct regions were significantly greater in the patch group compared with the control group (P < .05).Conclusion: Regional application of a simple, passive synthetic epicardial patch increased LV wall thickness at the infarct region, attenuated LV dilation, and improved LVEF and +dP/dt in a large animal model of MI. (J Cardiac Fail 2010;16:590-598)