An elastic, biodegradable cardiac patch induces contractile smooth muscle and improves cardiac remodeling and function in subacute myocardial infarction
An elastic, biodegradable cardiac patch induces contractile smooth muscle and improves cardiac remodeling and function in subacute myocardial infarction
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DOI：
10.1016/j.jacc.2007.02.050
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发表时间：
2007-06-12
影响因子：
24
通讯作者：
Wagner, William R.
中科院分区：
文献类型：
--
作者：
Fujimoto, Kazuro L.;Tobita, Kimimasa;Wagner, William R.
本研究的目的是将一种弹性的、可生物降解的聚氨基甲酸乙酯脲（PEUU）心脏贴片应用于亚急性梗死，并观察由此产生的心室重构和表现。背景心肌梗死会导致可收缩肿块的丧失和瘢痕的形成，导致不良的左心室重塑和随之而来的严重功能障碍。方法Lewis大鼠行左近端冠状动脉结扎术。冠脉结扎术后2周，在梗死左室壁表面直接植入直径6 mm的微孔PEUU贴片（PEUU贴片组，n = 14）。假手术作为梗死对照组（n = 12）。观察膜片植入8周后左室收缩功能、局部心肌壁顺应性及组织组织学变化。结果PEUU贴片组左室舒张末期腔面积（EDA）无变化，分数面积变化（FAC）升高（p < 0.05），梗死对照组EDA升高，FAC降低（p < 0.05）。PEUU贴片植入8周后吸收较多，左室壁较梗死对照组厚（p < 0.05）。PEUU组梗死心肌可见丰富的平滑肌束，具有成熟的收缩表型。PEUU组心肌顺应性分布在正常心肌和梗死对照组之间（p < 0.001）。结论新型可生物降解PEUU贴片植入亚急性心肌梗死后，可促进收缩型平滑肌组织形成，改善慢性期心脏重构和收缩功能。我们的研究结果为梗死后心力衰竭提供了一种新的治疗选择。
Objectives Our objective in this study was to apply an elastic, biodegradable polyester urethane urea (PEUU) cardiac patch onto subacute infarcts and to examine the resulting cardiac ventricular remodeling and performance.Background Myocardial infarction induces loss of contractile mass and scar formation resulting in adverse left ventricular (LV) remodeling and subsequent severe dysfunction.Methods Lewis rats underwent proximal left coronary ligation. Two weeks after coronary ligation, a 6-mm diameter microporous PEUU patch was implanted directly on the infarcted LV wall surface (PEUU patch group, n = 14). Sham surgery was performed as an infarction control (n = 12). The LV contractile function, regional myocardial wall compliance, and tissue histology were assessed 8 weeks after patch implantation.Results The end-diastolic LV cavity area (EDA) did not change, and the fractional area change (FAC) increased in the PEUU patch group (p < 0.05 vs. week 0), while EDA increased and FAC decreased in the infarction control group (p < 0.05). The PEUU patch was largely resorbed 8 weeks after implantation and the LV wall was thicker than infarction control (p < 0.05 vs. control group). Abundant smooth muscle bundles with mature contractile phenotype were found in the infarcted myocardium of the PEUU group. The myocardial compliance of the PEUU group was distributed between normal myocardium and infarction control (p < 0.001).Conclusions Implantation of a novel biodegradable PEUU patch onto a subacute myocardial infarction promoted contractile phenotype smooth muscle tissue formation and improved cardiac remodeling and contractile function at the chronic stage. Our findings suggest a new therapeutic option against post-infarct cardiac failure.