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RESEARCH PRODUCT

Critical single proximal left arterial descending coronary artery stenosis to mimic chronic myocardial ischemia: a new model induced by minimal invasive technology.

Dietmar BeckerMarkus VosselerDirk ManefeldOliver KempskiHans-anton LehrBenjamin BierbachSebastian KuhnAndreas HelischMichael LauterbachHans-jürgen ReineckeStefan BothGeorg HorstickNico Abegunewardene

subject

Chronic myocardial ischemiaMalemedicine.medical_specialtyTime FactorsPhysiologySwinemedicine.medical_treatmentCritical IllnessIschemiaMyocardial IschemiaCollateral CirculationCoronary stenosisCoronary AngiographySeverity of Illness IndexVentricular Dysfunction LeftInternal medicineCoronary CirculationmedicineAnimalsAngioplasty Balloon CoronaryTomography Emission-Computed Single-PhotonVascular diseasebusiness.industryCoronary StenosisStentPig modelStroke Volumemedicine.diseaseCoronary VesselsFibrosisStenosisDisease Models AnimalPositron-Emission TomographyCirculatory systemChronic DiseaseCardiologyFemaleStentsCardiology and Cardiovascular MedicinebusinessEchocardiography Stress

description

<i>Background/Aims:</i> The present report examines a new pig model for progressive induction of high-grade stenosis, for the study of chronic myocardial ischemia and the dynamics of collateral vessel growth. <i>Methods:</i> Thirty-nine Landrace pigs were instrumented with a novel experimental stent (GVD stent) in the left anterior descending coronary artery. Eight animals underwent transthoracic echocardiography at rest and under low-dose dobutamine. Seven animals were examined by nuclear PET and SPECT analysis. Epi-, mid- and endocardial fibrosis and the numbers of arterial vessels were examined by histology. <i>Results:</i> Functional analysis showed a significant decrease in global left ventricular ejection fraction (24.5 ± 1.6%) 3 weeks after implantation. There was a trend to increased left ventricular ejection fraction after low-dose dobutamine stress (36.0 ± 6.6%) and a significant improvement of the impaired regional anterior wall motion. PET and SPECT imaging documented chronic hibernation. Myocardial fibrosis increased significantly in the ischemic area with a gradient from epi- to endocardial. The number of arterial vessels in the ischemic area increased and coronary angiography showed abundant collateral vessels of Rentrop class 1. <i>Conclusion:</i> The presented experimental model mimics the clinical situation of chronic myocardial ischemia secondary to 1-vessel coronary disease.

10.1159/000181545https://pubmed.ncbi.nlm.nih.gov/19077390