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Ann Thorac Surg 2002;74:507-513
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Effects of acute dynamic cardiomyoplasty in a goat model of chronic ventricular dilatation: part 1

Gil Bolotin, MD, PhD*a,b, Roberto Lorusso, MD, PhDc, Jan J. Schreuder, MD, PhDd, Hans G. Kaulbach, MDe, Gideon Uretzky, MDb, Frederik H. van der Veen, PhDa

a Department of Cardiology, Cardiovascular Research Institute Maastricht, University of Maastricht, Maastricht, The Netherlands
b Department of Cardiothoracic Surgery, Tel Aviv Medical Center, Tel Aviv, Israel
c Department of Cardiac Surgery, Civic Hospital, Brescia, Italy
d Department of Cardiac Surgery, St Raphael Hospital, Milan, Italy
e Department of Cardiac Surgery, Bundes Krankenhaus, Koblenz, Germany

Accepted for publication April 21, 2002.

* Address reprint requests to Dr Bolotin, Department of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv, 64239, Israel
e-mail: bolotin{at}netvision.net.il

Background. The acute effects of cardiomyoplasty in an experimental model of chronic dilated heart have not been thoroughly investigated. Therefore, a model of chronic left ventricular (LV) dilatation was created to accurately determine actual changes shortly after passive and active wrapped skeletal muscle.

Methods. A carotid-jugular shunt model in 8 goats was used to induce progressive dilatation of the cardiac ventricles. Geometric modifications induced by the arteriovenous shunt were monitored by transthoracic echocardiography. After 8 weeks, cardiomyoplasty was performed, and the acute hemodynamic changes obtained with static cardiomyoplasty soon after the wrapping procedure were determined. Hence, hemodynamic variables recorded during assisted cardiac beats were then compared with data collected with unassisted cardiac beats using the conductance catheter method to generate pressure-volume loops.

Results. During electrical stimulation of the unconditioned skeletal muscle wrapped around the dilated left ventricle, a significant increase in stroke volume (117 ± 48 mL versus 87 ± 38 mL; p < 0.05) was observed. Early wrapped latissimus dorsi muscle activation also induced a reduction in LV end-systolic volume (from 51 ± 28 mL to 27 ± 14 mL; p < 0.05) when compared with unassisted LV contraction.

Conclusions. In a chronic model of cardiac dilatation, acute dynamic cardiomyoplasty was shown to increase LV contractile performance and reduce LV volume. Further evaluation is necessary to show the effects of a conditioned wrapped muscle on LV systolic function and dimensions in the long-term.






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