Impact of cardiac support device combined with slow-release prostacyclin agonist in a canine ischemic cardiomyopathy model

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• 作者：Yasuhiko Kubota ; Shigeru Miyagawa ; Satsuki Fukushima ; Atsuhiro Saito ; Hiroshi Watabe ; Takashi Daimon ; Yoshiki Sakai ; Toshiaki Akita ; Yoshiki Sawa
• 关键词：16 ; 30 ; 31 ; 38.2
• 刊名：The Journal of Thoracic and Cardiovascular Surgery
• 出版年：March, 2014
• 年：2014
• 卷：147
• 期：3
• 页码：1081-1087
• 全文大小：726 K

文摘

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Background

The cardiac support device supports the heart and mechanically reduces left ventricular (LV) diastolic wall stress. Although it has been shown to halt LV remodeling in dilated cardiomyopathy, its therapeutic efficacy is limited by its lack of biological effects. In contrast, the slow-release synthetic prostacyclin agonist ONO-1301 enhances reversal of LV remodeling through biological mechanisms such as angiogenesis and attenuation of fibrosis. We therefore hypothesized that ONO-1301 plus a cardiac support device might be beneficial for the treatment of ischemic cardiomyopathy.

Methods

Twenty-four dogs with induced anterior wall infarction were assigned randomly to 1 of 4 groups at 1聽week postinfarction as follows: cardiac support device alone, cardiac support device plus ONO-1301 (hybrid therapy), ONO-1301 alone, or sham control.

Results

At 8 weeks post-infarction, LV wall stress was reduced significantly in the hybrid therapy group compared with the other groups. Myocardial blood flow, measured by positron emission tomography, and vascular density were significantly higher in the hybrid therapy group compared with the cardiac support device alone and sham groups. The hybrid therapy group also showed the least interstitial fibrosis, the greatest recovery of LV systolic and diastolic functions, assessed by multidetector computed tomography and cardiac catheterization, and the lowest plasma N-terminal pro-B-type natriuretic peptide levels (P聽<聽.05).

Conclusions

The combination of a cardiac support device and the prostacyclin agonist ONO-1301 elicited a greater reversal of LV remodeling than either treatment alone, suggesting the potential of this hybrid therapy for the clinical treatment of ischemia-induced heart failure.