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(Circulation. 2001;104:I-241.)
© 2001 American Heart Association, Inc.

Thoracic Transplantation and Ventricular Assist Devices

Initial Effects of the Left Ventricular Repair by Plication May Not Last Long in a Rat Ischemic Cardiomyopathy Model

Takeshi Nishina, MD; Kazunobu Nishimura, MD; Sadatoshi Yuasa, MD; Senri Miwa, MD; Takuya Nomoto, MD; Yutaka Sakakibara, MD; Nobuhiro Handa, MD; Ichiro Hamanaka, MD; Yoshihiko Saito, MD; Masashi Komeda, MD

Departments of Cardiovascular Surgery (T. Nishina., K.N., S.M., T. Nomoto, Y.S., N.H., M.K.) and Medicine and Clinical Science (I.H., Y.S.), Kyoto University Graduate of School of Medicine, Kyoto, and Department of Cardiovascular Surgery, Matsue Red Cross Hospital (S.Y.), Matue, Japan.

Correspondence to Masashi Komeda, MD, Professor and Chairman, Department of Cardiovascular Surgery, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan 606-8507. E-mail masakom{at}kuhp.kyoto-u.ac.jp

Background— Long term effects of left ventricle (LV) repair surgery (LVR) for ischemic cardiomyopathy are not well understood.

Methods and Results— Sixty-nine rats developed ischemic cardiomyopathy with large akinetic LV area 4 weeks after the left anterior descending artery was ligated. In a second surgery 4 weeks later, 33 rats underwent LVR by plication of the akinetic LV area (LVR group), and 36 underwent rethoracotomy alone (sham group). No medication was used in either group. All rats survived the second surgery. LV end-diastolic dimension as measured by echocardiography, LV fractional shortening, and the maximal end-systolic pressure-volume relationship (E_max) as calculated from the data by catheter-tipped manometer and echocardiography improved in the LVR group after the second surgery, but LV end-diastolic dimension and E_max gradually deteriorated as time passed. LV end-diastolic pressure improved 1 week after LVR but rose significantly 4 weeks after LVR. Brain natriuretic peptide mRNA was lower in the LVR group than in the sham group 1 week after LVR but not 4 weeks postoperatively.

Conclusions— Initial improvement in LV function and neurohormonal status after LVR did not last for 4 weeks in this rat model when untreated medically. The mechanism of deterioration should be elucidated to improve long-term results of LVR.

Key Words: surgery • ischemia • cardiomyopathy • infarction • natriuretic peptides