Abstract 14172: Validation of the Noga 3D Left Ventricular Electromechanical Mapping System for Assessment of Cardiac Function and Localized Transendocardial Stem Cell Injection in a Porcine Ischemia-Reperfusion Model
Introduction: As ischemic heart disease continues to be a major cause of mortality, novel strategies of measuring cardiac function and delivering therapeutics are warranted. The NOGA mapping system (BioSense Webster) allows measurement of cardiac function and localizes areas of myocardial infarction (MI).
Hypothesis: The NOGA mapping system accurately measures cardiac function and maps the infarct zone. It is an effective method of delivering therapeutics via transendocardial injection.
Methods: Yorkshire pigs underwent 90 minutes of myocardial ischemia via inflation of a balloon angioplasty catheter in the left anterior descending artery. This was followed by a 30 minute reperfusion period. Two-dimensional echocardiogram (ECHO) and NOGA were used to obtain ejection fraction (EF) at baseline and post-MI. Gross morphometric analysis was used to identify injection sites and measure myocardial volume at risk.
Results: EF was decreased after ischemia-reperfusion (n=5) by 49% as measured by ECHO (63.6 vs. 32.0%, p=0.01) and by 47% by NOGA (66.9 to 35.6%, p<0.01). EF measurements were not significantly different between the two methods at baseline (63.6 vs. 66.9%, p=NS) or post-MI (32.0 vs. 35.6%, p=NS). This decline in cardiac function was associated with a mean infarct size of 18.1% (n=7) of at-risk ventricular volume based on gross morphometric analyses. NOGA generated infarct maps were consistent with direct in-vitro measurements of infarct size. Localized injection of fluorescent microspheres into the ischemic border zone using NOGA and the MyoStar catheter (Biosense Webster) were confirmed to be at the MI border zone by direct visualization in explanted tissue.
Conclusions: The NOGA mapping system accurately measures cardiac function and myocardial infarct size. It identifies the MI border zone and guides precise delivery of therapeutics to the region. This approach is useful for the delivery of novel therapeutics to specific regions of injured myocardium.
- © 2011 by American Heart Association, Inc.