Abstract 3253: Dermal Filler Injection: A Novel Approach for Limiting Early Infarct Expansion
Objectives Early infarct expansion promotes adverse remodeling and is associated with poor long-term prognosis. We hypothesized that thickening the infarcted territory of the LV wall by means of intramyocardial injection of a clinically available acellular hydroxyapatite-based dermal filler would attenuate infarct expansion and improve long-term remodeling after myocardial infarction.
Methods Twenty-five adult male sheep underwent coronary ligations that create an anteroapical MI. Fifteen animals subsequently underwent injection of 1.3 mL of a viscous hydroxyapatite based preparation into the infarcted territory - 10 served as controls. Rt-3DE was performed at baseline, 30 minutes post-MI, 30 minutes post-injection and then at 2, 4 and 8 weeks post-MI. LV volumes and EF were calculated in each case. Cardiac output was measured at 8 weeks with no inotropic stimulation and then during infusions of 2.5 and 5.0 mcg/kg/min of dobutamine after which all animals were sacrificed. Finally, LV wall thickness was measured within the basal and apical regions of the infarct zone, the borderzone (1 cm strip adjacent to the infarct) and the remote myocardium (base).
Results All data are presented in the figure⇓. LV remodeling was attenuated in the treatment animals compared with the control group. Treatment animals had thicker infarcts, higher baseline cardiac output and better response to inotropic stimulation than the control group.
Conclusions Early post-infarction intramyocardial thickening with an acellular hydroxyapatite gel attenuates LV remodeling and improves contractile function 8 weeks after an anteroapical MI in a clinically relevant large animal model.