Document Detail


Dermal filler injection: a novel approach for limiting infarct expansion.
MedLine Citation:
PMID:  19101288     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Early infarct expansion after coronary occlusion compromises contractile function in perfused myocardial regions and promotes adverse long-term left ventricular (LV) remodeling. We hypothesized that injection of a tissue-expanding dermal filler material into a myocardial infarction (MI) would attenuate infarct expansion and limit LV remodeling.
METHODS: Fifteen sheep were subjected to an anteroapical MI involving approximately 20% of the LV followed by the injection of 1.3 mL of a calcium hydroxyapatite-based dermal filler into the infarct. Real-time three-dimensional echocardiography was performed at baseline, 30 minutes after MI, and 15 minutes after injection to assess infarct expansion. Sixteen additional sheep were subjected to the same infarction and followed echocardiographically and hemodynamically for 4 weeks after MI to assess chronic remodeling. Eight animals had injection with dermal filler as described above immediately after MI, and 8 animals were injected with an equal amount of saline solution.
RESULTS: All animals exhibited infarct expansion soon after coronary occlusion. The regional ejection fraction of the apex became negative after infarction, consistent with systolic dyskinesia. Injection of the dermal filler converted the apical wall motion from dyskinetic to akinetic and resulted immediately in significant decreases in global, regional, and segmental LV volumes. Chronically, relative to saline control, dermal filler injection significantly reduced LV end-systolic volume (62.2 +/- 3.6 mL versus 44.5 +/- 3.9 mL; p < 0.05) and improved global ejection fraction (0.295 +/- 0.016 versus 0.373 +/- 0.017; p < 0.05) at 4 weeks after infarction.
CONCLUSIONS: Injection of an acellular dermal filler into an MI immediately after coronary occlusion reduces early infarct expansion and limits chronic LV remodeling.
Authors:
Liam P Ryan; Kanji Matsuzaki; Mio Noma; Benjamin M Jackson; Thomas J Eperjesi; Theodore J Plappert; Martin G St John-Sutton; Joseph H Gorman; Robert C Gorman
Related Documents :
1973968 - Association of sleep apnoea with myocardial infarction in men.
3746148 - Non-invasive detection of coronary artery disease by body surface electrocardiographic ...
16310268 - Analysis of coronary calcifications versus framingham and procam risk assessment in pat...
6607358 - Circulating immune complexes in myocardial infarction.
18373598 - Implications of obstructive sleep apnea for atrial fibrillation and sudden cardiac death.
16221258 - Chronotropic incompetence in patients with an implantable cardioverter defibrillator: p...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  87     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-22     Completed Date:  2009-01-22     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  148-55     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Biopsy, Needle
Dermatologic Agents / pharmacology
Disease Models, Animal
Disease Progression
Durapatite / pharmacology*
Echocardiography, Transesophageal
Gels / pharmacology
Immunohistochemistry
Injections, Intralesional
Male
Microspheres
Myocardial Contraction / drug effects
Myocardial Infarction / drug therapy*,  pathology,  ultrasonography
Probability
Random Allocation
Reference Values
Sensitivity and Specificity
Ventricular Remodeling / drug effects*,  physiology
Grant Support
ID/Acronym/Agency:
HL63954/HL/NHLBI NIH HHS; HL71137/HL/NHLBI NIH HHS; HL76560/HL/NHLBI NIH HHS; R01 HL063954/HL/NHLBI NIH HHS; R01 HL063954-09/HL/NHLBI NIH HHS; R01 HL071137-04/HL/NHLBI NIH HHS; R01 HL076560-04/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Dermatologic Agents; 0/Gels; 1306-06-5/Durapatite
Comments/Corrections
Comment In:
Ann Thorac Surg. 2009 Jan;87(1):155-6   [PMID:  19101289 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  N-acetylcysteine in cardiovascular-surgery-associated renal failure: a meta-analysis.
Next Document:  Mild hypothermia to limit myocardial ischemia-reperfusion injury: importance of timing.