An experimental model of myocardial infarction and controlled reperfusion using a miniaturized cardiopulmonary bypass in rats
An experimental model of myocardial infarction and controlled reperfusion using a miniaturized cardiopulmonary bypass in rats
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DOI：
10.1093/icvts/ivu187
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发表时间：
2014-10-01
影响因子：
--
通讯作者：
Khaladj, Nawid
中科院分区：
文献类型：
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作者：
Peterss, Sven;Guenther, Sabina;Khaladj, Nawid
目的：急性心肌梗死（AMI）患者存在不同的血运重建策略。目前尚不清楚使用体外循环（CPB）或体外生命支持（ECLS）进行心室卸载是否对早期脑缺血后心室功能有影响。在这里，我们报告了在AMI动物模型中使用小型化CPB的方法的结果。方法：随机选择30只雄性Wistar大鼠进行临时左前降（LAD）结扎术（30分钟），然后再灌注180分钟，加或不加60分钟CPB （70 ml/min, 36℃）。CPB回路由静脉储液器、蠕动滚筒泵和带热交换器的膜氧合器组成。在再灌注后60和120分钟（F60, F120）用导尿管测量心功能。结果：死亡率为37%（11/30）。因此，19只动物可以被纳入分析（8 CPB）。F60 [63 +/- 29 vs 54 +/- 25 ml/min (CPB), P = 0.56]和F120 [73 +/- 27 vs 53 +/- 24 ml/min (CPB), P = 0.21]组间平均心输出量无差异。再灌注时，对照组（F60 37 +/- 5% vs F120 33 +/- 8%, P = 0.42）和CPB组（F60 52 +/- 11% vs F120 51 +/- 13%, P = 0.71）的平均左室射血分数（LVEF）稳定。CPB动物再灌注后LVEF明显改善（F60 P = 0.007, F120 P = 0.01）。结论：在AMI动物模型中，CPB的建立使LVEF明显优于常规再灌注。这种有益的作用可能会对未来AMI患者的血运重建策略和时机产生影响。
OBJECTIVES: Different revascularization strategies for patients with acute myocardial infarction (AMI) exist. It remains unclear whether ventricular unloading using cardiopulmonary bypass (CPB) or extracorporeal life support (ECLS) has an impact on early postischaemic ventricular function. Here, we report on the results of an approach using a miniaturized CPB in a well-established animal model of AMI.METHODS: In a randomized fashion, 30 male Wistar rats were assigned to temporary left anterior descending (LAD) ligation (30 min) followed by 180 min of reperfusion either with or without 60 min of CPB (70 ml/min, 36 degrees C). The CPB circuit consisted of a venous reservoir, a peristaltic roller pump and a membrane oxygenator with heat exchanger. Cardiac function was measured at 60 and 120 min after reperfusion (F60, F120) using a conductance catheter.RESULTS: The mortality rate was 37% (11/30). Thus, 19 animals could be included into the analysis (8 CPB). The mean cardiac output did not differ between the groups at F60 [63 +/- 29 vs 54 +/- 25 ml/min (CPB), P = 0.56] and F120 [73 +/- 27 vs 53 +/- 24 ml/min (CPB), P = 0.21]. During reperfusion, the mean left ventricular ejection fraction (LVEF) was stable in both the control (F60 37 +/- 5% vs F120 33 +/- 8%, P = 0.42) and the CPB groups (F60 52 +/- 11% vs F120 51 +/- 13%, P = 0.71). CPB animals had a significantly better LVEF after reperfusion (F60 P = 0.007, F120 P = 0.01).CONCLUSIONS: In this animal model of AMI, the establishment of CPB resulted in a significantly better LVEF in comparison with conventional reperfusion only. This beneficial effect may have an impact on revascularization strategies and timing in patients presenting with AMI in the future.