Passive ventricular constraint to improve left ventricular function and mechanics in an ovine model of heart failure secondary to acute myocardial infarction.
Passive ventricular constraint to improve left ventricular function and mechanics in an ovine model of heart failure secondary to acute myocardial infarction.
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被动心室约束可改善急性心肌梗死继发心力衰竭羊模型的左心室功能和力学。
DOI：
10.1016/s0022-5223(03)00739-6
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
M. Acker
中科院分区：
文献类型：
--
作者：
J. Pilla;A. S. Blom;D. Brockman;V. Ferrari;Q. Yuan;M. Acker
目的探讨涤纶编织套心脏支持装置对心肌梗死后进行性扩张的影响。我们假设放置心脏支持装置可以减少心肌壁应力，改善心功能和心肌能量学。方法采用压力-体积分析和磁共振成像技术，研究被动约束对10只羊左心室功能和力学的影响。在基线研究之后出现了前侧梗死。1周后，动物进行第二次研究。将心脏支持装置置于5只羊的心外膜上；其余的动物作为对照。梗塞后2个月进行终末研究。结果与对照组相比，心脏支持装置组舒张末期容积降低（对照组110.3±19.8 mL，心脏支持装置67.6±4.7 mL, P = 0.006），射血分数提高（对照组15.5%±5.7%，心脏支持装置29.46%±4.42%,P = 0.008）。心脏支持装置组的心肌能量也有所增强，其中势能（对照组2015±503 mL·mm Hg/次vs心脏支持装置885±220 mL·mm Hg/次，P = 0.006）、效率（对照组39.4%±13.6% vs心脏支持装置59.8%±8.5%,P = 0.044）和耗氧量（对照组0.072±0.013 mL O2/次vs心脏支持装置0.052±0.007 mL O2/次，P = 0.034）均有显著改善。结论心肌梗死后心脏支持装置的被动约束可阻止心肌重构的进一步发展，并可能刺激急性心肌梗死继发心力衰竭的逆转重构。这些结果表明，在人类大面积前壁心肌梗死后放置心脏支持装置可能有效阻止经常导致终末期心力衰竭的重构过程。如果被证明是有效的，在大面积心脏病发作后放置心脏支持装置有可能降低大面积心肌梗死后心力衰竭的发生率。
OBJECTIVEThis study investigated the effects on global cardiac function and myocardial energetics of limiting progressive dilatation after infarction by means of a woven polyester jacket cardiac support device. We hypothesized that placement of the cardiac support device results in a decrease in myocardial wall stress and improvement in cardiac function and myocardial energetics.METHODSTo investigate the effect of passive constraint on left ventricular function and mechanics, a total of 10 sheep were studied with pressure-volume analysis and magnetic resonance imaging. A baseline study was followed by the creation of an anterior infarct. After 1 week, the animals underwent a second study. The cardiac support device was then placed over the epicardium in 5 sheep; the remaining animals served as controls. A terminal study was performed at 2 months after the infarct.RESULTSThe cardiac support device group at the terminal study exhibited a decrease in end-diastolic volume (control 110.3 ± 19.8 mL vs cardiac support device 67.6 ± 4.7 mL, P = .006) and an improved ejection fraction (control 15.5% ± 5.7% vs cardiac support device 29.46% ± 4.42%, P = .008) relative to the control group. Myocardial energetics were also enhanced in the cardiac support device group, as evidenced by the significant improvements in potential energy (control 2015 ± 503 mL · mm Hg/beat vs cardiac support device 885 ± 220 mL · mm Hg/beat, P = .006), efficiency (control 39.4% ± 13.6% vs cardiac support device 59.8% ± 8.5%, P = .044), and oxygen consumption (control 0.072 ± 0.013 mL O2/beat vs cardiac support device 0.052 ± 0.007 mL O2/beat, P = .034).CONCLUSIONPassive constraint with the cardiac support device after infarct prevents further remodeling and may stimulate reverse remodeling in heart failure secondary to acute myocardial infarction. These results suggest that in human beings placement of the cardiac support device after a large anterior myocardial infarction may be effective in halting the remodeling process that often leads to end-stage heart failure. If proved effective, placement of a cardiac support device after large heart attacks has the potential to decrease the incidence of heart failure that results after large myocardial infarctions.
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影响因子：
37.8
作者：
R. Edwards;M. Marber
通讯作者：
R. Edwards;M. Marber
影响因子：
37.8
作者：
GLOWER, DD;SPRATT, JA;RANKIN, JS
通讯作者：
RANKIN, JS
影响因子：
37.8
作者：
KASS, DA;YAMAZAKI, T;SAGAWA, K
通讯作者：
SAGAWA, K
影响因子：
158.5
作者：
PFEFFER, MA;LAMAS, GA;BRAUNWALD, E
通讯作者：
BRAUNWALD, E