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REVERSING LEFT VENTRICULAR REMODELING: ACUTE RESULTS FROM EPICARDIAL CATHETER-BASED VENTRICULAR RECONSTRUCTION IN AN OVINE HEART FAILURE MODEL
A17.E159 JACC March 9, 2010 Volume 55, issue 10A
CARDIAC FUNCTION AND HEART FAILURE REVERSING LEFT VENTRICULAR REMODELING: ACUTE RESULTS FROM EPICARDIAL CATHETER-BASED VENTRICULAR RECONSTRUCTION IN AN OVINE HEART FAILURE MODEL ACC Oral Contributions Georgia World Congress Center, Room B408 Tuesday, March 16, 2010, 8:45 a.m.-9:00 a.m.
Session Title: Myocardial Recovery/Reverse Remodeling Abstract Category: Myocardial Function/Heart Failure--Clinical Nonpharmacological Treatment Presentation Number: 0916-06 Authors: Yanping Cheng, Michael Aboodi, Andrew Wechsler, Gerard Conditt, Diane Ordanes, Alyssa Flynn, Greg L Kaluza, Juan F Granada, Lon S Annest, Geng-hua Yi, Cardiovascular Research Foundation, Orangeburg, NY Background: Ischemic cardiomyopathy induced by myocardial infarction (MI) can cause left ventricular (LV) remodeling resulting in progressive dilatation and dysfunction, and has been treated with surgical volume reduction. The purpose of this study was to assess acute reduction in volume achieved with a minimally invasive device (BioVentrix, San Ramon, CA) for epicardial catheter-based ventricular reconstruction (ECVR), which enables exclusion of the LV scar in an ovine MI model, thereby creating a geometric restoration of the dilated, failing LV. Methods: LV anteroapical MI was induced by LAD trans-catheter coil embolization. 60 days later, after scar maturation and establishment of heart failure (HF), ECVR, consisting of implantation of a series of anchor pairs to plicate the scarred LV wall, was performed in 11 sheep under fluoroscopic and echo guidance. LV performance was evaluated before and immediately after device implantation by echo. Results: During scar maturation, all animals developed HF characterized by a reduction in LV ejection fraction (EF) and dilated LV chamber. After ECVR, LV end-diastolic diameter (EDD), end-diastolic volume (EDV), end-systolic diameter (ESD) and end-systolic volume (ESV) were significantly decreased while EF was significantly increased (Data summarized in Table). Conclusions: ECVR acutely reduces and reshapes the left ventricle, improves LV function and reverses indices of LV remodeling in an MI-induced HF ovine model. EDD (cm)
ESD (cm)
EDV (ml)
ESV (ml)
EF%
Baseline
3.85±0.22
2.79±0.21
50.3±8.2
20.4±3.7
59.5±0.2
Pre-device
4.49±0.65*
3.42±0.83*
80.6±23.2*
48.5±18.3*
41.0±6.6*
Post-device
4.00±0.20#
2.86±0.32#
55.9±13.6#
26.1±7.7#
53.8±3.9#*
% Change (postcompared to predevice)
-9.8±10.1%
-13.5±13.9%
-26.5±20.7%
-41.0±19.4%
12.8±7.0%
Mean ± SD. *P<0.05 vs. baseline; #P<0.05 vs. pre-device.
CARDIAC FUNCTION AND HEART FAILURE REVERSING LEFT VENTRICULAR REMODELING: ACUTE RESULTS FROM EPICARDIAL CATHETER-BASED VENTRICULAR RECONSTRUCTION IN AN OVINE HEART FAILURE MODEL ACC Oral Contributions Georgia World Congress Center, Room B408 Tuesday, March 16, 2010, 8:45 a.m.-9:00 a.m.
Session Title: Myocardial Recovery/Reverse Remodeling Abstract Category: Myocardial Function/Heart Failure--Clinical Nonpharmacological Treatment Presentation Number: 0916-06 Authors: Yanping Cheng, Michael Aboodi, Andrew Wechsler, Gerard Conditt, Diane Ordanes, Alyssa Flynn, Greg L Kaluza, Juan F Granada, Lon S Annest, Geng-hua Yi, Cardiovascular Research Foundation, Orangeburg, NY Background: Ischemic cardiomyopathy induced by myocardial infarction (MI) can cause left ventricular (LV) remodeling resulting in progressive dilatation and dysfunction, and has been treated with surgical volume reduction. The purpose of this study was to assess acute reduction in volume achieved with a minimally invasive device (BioVentrix, San Ramon, CA) for epicardial catheter-based ventricular reconstruction (ECVR), which enables exclusion of the LV scar in an ovine MI model, thereby creating a geometric restoration of the dilated, failing LV. Methods: LV anteroapical MI was induced by LAD trans-catheter coil embolization. 60 days later, after scar maturation and establishment of heart failure (HF), ECVR, consisting of implantation of a series of anchor pairs to plicate the scarred LV wall, was performed in 11 sheep under fluoroscopic and echo guidance. LV performance was evaluated before and immediately after device implantation by echo. Results: During scar maturation, all animals developed HF characterized by a reduction in LV ejection fraction (EF) and dilated LV chamber. After ECVR, LV end-diastolic diameter (EDD), end-diastolic volume (EDV), end-systolic diameter (ESD) and end-systolic volume (ESV) were significantly decreased while EF was significantly increased (Data summarized in Table). Conclusions: ECVR acutely reduces and reshapes the left ventricle, improves LV function and reverses indices of LV remodeling in an MI-induced HF ovine model. EDD (cm)
ESD (cm)
EDV (ml)
ESV (ml)
EF%
Baseline
3.85±0.22
2.79±0.21
50.3±8.2
20.4±3.7
59.5±0.2
Pre-device
4.49±0.65*
3.42±0.83*
80.6±23.2*
48.5±18.3*
41.0±6.6*
Post-device
4.00±0.20#
2.86±0.32#
55.9±13.6#
26.1±7.7#
53.8±3.9#*
% Change (postcompared to predevice)
-9.8±10.1%
-13.5±13.9%
-26.5±20.7%
-41.0±19.4%
12.8±7.0%
Mean ± SD. *P<0.05 vs. baseline; #P<0.05 vs. pre-device.