© 1999 by European Society of Cardiology
Copyright © 1999, European Society of Cardiology
Passive ventricular constraint amends the course of heart failure: a study in an ovine model of dilated cardiomyopathy
aDepartment of Medicine, University of Melbourne (Austin and Repatriation Medical Centre Campus), Melbourne, Australia
bDepartment of Cardiothoracic Surgery, University of Melbourne (Austin and Repatriation Medical Centre Campus), Melbourne, Australia
cDepartment of Public Health and Community Medicine, University of Melbourne (Parkville Campus), Melbourne, Australia
dAcorn Cardiovascular Inc., St. Paul, MN, USA
* Corresponding author. Tel.: +61-3-9496-4090; fax: +61-3-9496-4099 jmp{at}austin.unimelb.edu.au
Objective: Dilated cardiomyopathy (DCM) is associated with a progressive deterioration in cardiac function. We hypothesised that some of the deleterious effects of DCM could be reduced by mechanically limiting the degree of cardiac dilatation. Methods: A Transonic 20A cardiac output (CO) flow-probe was implanted in the pulmonary artery of 12 adult (52±4 kg) sheep. Early heart failure was created by rapid right ventricular (RV) pacing for 21 days at a rate which resulted in an initial 10% decrease in CO (to a maximum of 190 bpm). A custom polyester jacket (Acorn Cardiovascular, St Paul, MN) was then placed, via a partial lower sternotomy, on the ventricular epicardium of all sheep. Animals were randomised either to jacket retention (wrap) or removal (sham). Pacing was recommenced at a higher rate (that initiated a further 10% decrease in CO) for 28 days. Haemodynamic and echocardiographic parameters were determined at baseline, implant and at termination. Results: At termination, the left ventricular fractional shortening was significantly higher (p=0.03), the degree of mitral valve regurgitation lower (scaled 0–3) (p=0.03) and the left ventricular long axis area smaller (p=0.02) in the wrap animals compared with sham. Conclusions: In this model of heart failure, ventricular constraint with a polyester jacket diminished the deterioration in cardiac function associated with progressive dilated cardiomyopathy. These results suggest that maintainance of a more normal cardiac size and shape may be beneficial in patients with dilated cardiomyopathy.
KEYWORDS Heart failure; Cardiomyopathy; Ventricular function; Remodelling
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