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J Thorac Cardiovasc Surg 2009;137:180-187
© 2009 The American Association for Thoracic Surgery

Evolving Technology

Restoration of left ventricular geometry and improvement of left ventricular function in a rodent model of chronic ischemic cardiomyopathy

Jiashing Yu, BSa, Karen L. Christman, PhDa, Eric Chin, BSc, Richard E. Sievers, BSc, Maythem Saeed, PhDb, Randall J. Lee, MD, PhDa,c,*

a University of California Berkeley and University of California San Francisco Joint Bioengineering Graduate Group, Berkeley/San Francisco, Calif
b Department of Radiology, University of California, San Francisco, Calif
c Cardiovascular Research Institute and Department of Medicine, University of California, San Francisco, Calif

Received for publication April 21, 2008; revisions received July 23, 2008; accepted for publication August 21, 2008.

* Address for reprints: Randall J. Lee, MD, PhD, 500 Parnassus Ave, Cardiac Electrophysiology, MU East Tower, Box 1354. San Francisco, CA 94143. (Email: lee{at}medicine.ucsf.edu).

Objectives: Various approaches to myocardial reconstruction have been developed for the treatment of congestive heart failure resulting from ischemic cardiomyopathy.

Methods: In this study we determined whether in situ application of polymers could reshape left ventricular geometry in a chronic rodent model of ischemic cardiomyopathy.

Results: We demonstrate that alginate and fibrin can augment left ventricular wall thickness, resulting in reconstruction of left ventricular geometry and improvement of cardiac function. Echocardiographic results at 5 weeks after injection of alginate demonstrated persistent improvement of left ventricular fractional shortening and prevention of a continued enlargement of left ventricular dimensions, whereas fibrin glue demonstrated no progression of left ventricular negative remodeling. There was increased arteriogenesis in both the alginate and fibrin glue groups compared with that seen in the phosphate-buffered saline control group. Infarct size was significantly reduced in the fibrin group (P < .05), and there was a trend toward a smaller myocardial infarction in the alginate group.

Conclusion: Intramyocardially injected polymers can be used to reshape the aneurysmal left ventricle and might therefore be an approach for myocardial reconstruction and a potential option in treating chronic heart failure in human subjects.

Abbreviations and Acronyms ECM = extracellular matrix; LV = left ventricular; LVID = left ventricular internal dimension; MI = myocardial infarction; MRI = magnetic resonance imaging; PBS = phosphate-buffered saline; RGD = arginine-glycine-asparagine






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