| Dermal filler injection: a novel approach for limiting infarct expansion. | |
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MedLine Citation:
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PMID: 19101288 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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 |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 87 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2008-12-22 Completed Date: 2009-01-22 Revised Date: 2012-12-21 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 148-55 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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0/Dermatologic Agents; 0/Gels; 1306-06-5/Durapatite |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2009 Jan;87(1):155-6
[PMID:
19101289
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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