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Effects of pulmonary artery banding in doxorubicin-induced left ventricular cardiomyopathy
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Yerebakan, Can, Boltze, Johannes, Elmontaser, Hatem, Yoruker, Uygar, Latus, Heiner, Khalil, Markus, Ostermayer, Stefan, Steinbrenner, Blanca, Apitz, Christian, Schneider, Matthias, Suchowski, Marcel, Ruetten, Rita, Mueller, Kristin, Kerst, Gunther, Schranz, Dietmar and Akintuerk, Hakan (2019) Effects of pulmonary artery banding in doxorubicin-induced left ventricular cardiomyopathy. The Journal of Thoracic and Cardiovascular Surgery, 157 (6). pp. 2416-2428. doi:10.1016/j.jtcvs.2019.01.138 ISSN 0022-5223.
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Official URL: http://dx.doi.org/10.1016/j.jtcvs.2019.01.138
Abstract
Objective
Central pulmonary banding has been proposed as a novel alternative for the treatment of left ventricular dilated cardiomyopathy in children. We sought to investigate the effects of central pulmonary banding in an experimental model of doxorubicin-induced left ventricular dilated cardiomyopathy.
Methods
Four-month-old sheep (n = 28) were treated with intermittent intracoronary injections of doxorubicin (0.75 mg/kg/dose) into the left main coronary artery. A total dose of up to 2.15 mg/kg of doxorubicin was administered until signs of left ventricular dilation with functional impairment occurred by transthoracic echocardiography evaluation. Animals that survived were treated with surgical central pulmonary banding through a left anterior thoracotomy or sham surgery. Transthoracic echocardiography and pressure-volume loop measurements were used to compare left ventricular function preoperatively and 3 months later. Macroscopic and microscopic histologic examinations followed after hearts were harvested.
Results
Nine animals from the central pulmonary banding group and 8 animals from the sham group survived and were included in the final analysis. Both groups showed similar inflammation and fibrosis upon histologic examination consistent with the toxic myocardial effects of doxorubicin. There were no differences in the echocardiographic measurements before central pulmonary banding or sham operation. Baseline measurements before the central pulmonary banding/sham operation were considered as 100%. The central pulmonary banding group had better left ventricular ejection fraction (102.5% ± 21.6% vs 76.7% ± 11.7%, P = .01), with a tendency for smaller left ventricular end-diastolic (101.2% ± 7.4% vs 120.4% ± 10.8%, P = .18) and significantly smaller end-systolic (100.3% ± 12.9% vs 116.5 ± 9.6%, P = .02) diameter of the left ventricle in comparison with the sham animals at 3 months. The end-systolic volume (101.4% ± 31.6% vs 143.4% ± 28.6%, P = .02) was significantly lower in the central pulmonary banding group 3 months postoperatively. Fractional shortening in the long axis (118.5% ± 21.5% vs 85.2% ± 22.8%, P = .016) and short axis (122.5% ± 18% vs 80.9% ± 13.6%, P = .0005) revealed significantly higher values in the central pulmonary banding group. In the conductance catheter measurements, no significant differences were seen between the groups for the parameters of systolic and diastolic function.
Conclusions
Central pulmonary artery banding in the setting of experimental toxic left ventricular dilated cardiomyopathy improved left ventricular echocardiographic function and dimensions.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||
| Journal or Publication Title: | The Journal of Thoracic and Cardiovascular Surgery | ||||||||
| Publisher: | Elsevier | ||||||||
| ISSN: | 0022-5223 | ||||||||
| Official Date: | June 2019 | ||||||||
| Dates: |
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| Volume: | 157 | ||||||||
| Number: | 6 | ||||||||
| Page Range: | pp. 2416-2428 | ||||||||
| DOI: | 10.1016/j.jtcvs.2019.01.138 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Description: | Read at the 98th Annual Meeting of The American Association for Thoracic Surgery, San Diego, California, April 28-May 1, 2018. |
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