Biodegradable elastic patch plasty ameliorates left ventricular adverse remodeling after ischemia-reperfusion injury: A preclinical study of a porous polyurethane material in a porcine model

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• 作者：Ryotaro Hashizume ; Kazuro L. Fujimoto ; Yi Hong ; Jianjun Guan ; Catalin Toma ; Kimimasa Tobita ; William R. Wagner
• 关键词：¦ÁSMA ; ¦Á-smooth muscle actin ; EDA ; end-diastolic area ; EF ; ejection fraction ; ESA ; end-systolic area ; % FAC ; fractional area change ; LV ; left ventricular (ventricle) ; LVEDV ; left ventricular end-diastolic volume ; LVESV ; left ventricular end-systolic volum
• 刊名：The Journal of Thoracic and Cardiovascular Surgery
• 出版年：2013
• 出版时间：August, 2013
• 年：2013
• 卷：146
• 期：2
• 页码：391-399.e1
• 全文大小：3617 K

文摘

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Objective

Myocardial infarction (MI) can lead to irreversible adverse left ventricular remodeling resulting in subsequent severe dysfunction. The objective of this study was to investigate the potential for biodegradable, elastomeric patch implantation to positively alter the remodeling process after MI in a porcine model.

Methods

Yorkshire pigs underwent a 60-minute catheter balloon occlusion of the left circumflex artery. Two weeks after MI animals underwent epicardial placement of a biodegradable, porous polyurethane (poly(ester urethane)urea; PEUU) patch (MI+PEUU, n?=?7) or sham surgery (MI+sham, n?=?8). Echocardiography before surgery and at 4 and 8 weeks after surgery measured the end-diastolic area (EDA) and fractional area change ( % FAC). All animals were humanely killed 8 weeks after surgery and hearts were histologically assessed.

Results

At 8 weeks, echocardiography revealed greater EDA values in the MI+sham group (23.6 ¡À 6.6 cm², mean ¡À standard deviaation) than in the MI+PEUU group (15.9 ¡À 2.5 cm²) (P?<?.05) and a lower % FAC in the MI+sham group (24.8 ¡À 7.6) than in the MI+PEUU group (35.9 ¡À 7.8) (P?<?.05). The infarcted ventricular wall was thicker in the MI+PEUU group (1.56 ¡À 0.5 cm) than in the MI+sham group (0.91 ¡À 0.24 cm) (P?<?.01).

Conclusions

Biodegradable elastomeric PEUU patch implantation onto the porcine heart 2 weeks post-MI attenuated left ventricular adverse remodeling and functional deterioration and was accompanied by increased neovascularization. These findings, although limited to a 2-month follow-up, may suggest an attractive clinical option to moderate post-MI cardiac failure.