Effects of pulmonary artery banding in doxorubicin-induced left ventricular cardiomyopathy

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. Four...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 2019-06, Vol.157 (6), p.2416-2428.e4
Main Authors: 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, Akintuerk, Hakan
Format: Article
Language:English
Subjects:
Animals
cardiomyopathy
Cardiomyopathy, Dilated - chemically induced
Cardiomyopathy, Dilated - diagnostic imaging
Cardiomyopathy, Dilated - physiopathology
Cardiomyopathy, Dilated - surgery
Coronary Angiography
Disease Models, Animal
Doxorubicin - pharmacology
Echocardiography, Transesophageal
heart failure
Hemodynamics
left ventricle
Pulmonary Artery - surgery
pulmonary artery banding
Sheep
Ventricular Function, Left
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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. 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. 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. Central pulmonary artery banding in the setting of experimental toxic left ventr
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2019.01.138