JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2002; 39:2069-2076
© 2002 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Saavedra, W. F.
Right arrow Articles by Kass, D. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Saavedra, W. F.
Right arrow Articles by Kass, D. A.

EXPERIMENTAL STUDY

Reverse remodeling and enhancedadrenergic reserve from passive externalsupport in experimental dilated heart failure

W. Federico Saavedra, MD*, Richard S. Tunin, MS*, Nazareno Paolocci, MD, PhD*, Takayuki Mishima, MD{dagger}, George Suzuki, MD{dagger}, Charles W. Emala, MD{ddagger}, Pervaiz A. Chaudhry, MD{dagger}, Petros Anagnostopoulos, MD{dagger}, Ramesh C. Gupta, PhD{dagger}, Hani N. Sabbah, PhD, FACC{dagger} and David A. Kass, MD, FAHA*,*

* Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
{dagger} Division of Cardiovascular Medicine, Henry Ford Health System, Detroit, Michigan, USA
{ddagger} Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York, USA

Manuscript received November 2, 2001; revised manuscript received March 5, 2002, accepted March 27, 2002.

* Reprint requests and correspondence: Dr. David A. Kass, Halsted 500, Johns Hopkins Medical Institutions, 600 N. Wolfe Street, Baltimore, Maryland 21287, USA.
dkass{at}bme.jhu.edu

OBJECTIVES: We sought to test the efficacy of a passive elastic containment device to reverse chronic chamber remodeling and adrenergic down-regulation in the failing heart, yet still maintaining preload reserve.

BACKGROUND: Progressive cardiac remodeling due to heart failure is thought to exacerbate underlying myocardial dysfunction. In a pressure–volume analysis, we tested the impact of limiting progressive cardiac dilation by an externally applied passive containment device on both basal and adrenergic-stimulated function in failing canine hearts.

METHODS: Ischemic dilated cardiomyopathy was induced by repeated intracoronary microembolizations in six dogs. The animals were studied before and three to six months after surgical implantation of a thin polyester mesh (cardiac support device [CSD]) that surrounded both cardiac ventricles. Pressure–volume relations were measured by a conductance micromanometer catheter.

RESULTS: Long-term use of the CSD lowered end-diastolic and end-systolic volumes by –19 ± 4% and –22 ± 8%, respectively (both p < 0.0001) and shifted the end-systolic pressure–volume relation to the left (p < 0.01), compatible with reverse remodeling. End-diastolic pressure and chamber diastolic stiffness did not significantly change. The systolic response to dobutamine markedly improved after CSD implantation (55 ± 8% rise in ejection fraction after CSD vs. –10 ± 8% before CSD, p < 0.05), in conjunction with a heightened adenylyl cyclase response to isoproterenol. There was no change in the density or affinity of beta-adrenergic receptors. Diastolic compliance was not adversely affected, and preload-recruitable function was preserved with the CSD, consistent with a lack of constriction.

CONCLUSIONS: Reverse remodeling with reduced systolic wall stress and improved adrenergic signaling can be achieved by passive external support that does not generate diastolic constriction. This approach may prove useful in the treatment of chronic heart failure.

Abbreviations and Acronyms
  ATP
  adenosine triphosphate
  cAMP
  cyclic adenosine monophosphate
  CSD
  cardiac support device
  DHA
  3H-dihydroalprenelol
  ESPVR
  end-systolic pressure–volume relation
  LV
  left ventricle
  LVAD
  left ventricular assist device
  PMSF
  phenylmethylsulfonyl fluoride
  RV
  right ventricle
  SDS
  sodium dodecyl sulfate




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
N. Valli, L. Labrousse, P. Reant, and P. Dos-Santos
Significant improvement of cardiac sympathetic function following cardiac support device implantation: illustration by 123I-MIBG scintigraphy
Eur. J. Cardiothorac. Surg., December 1, 2007; 32(6): 943 - 944.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
P. Ferrazzi, M. Senni, M. R. Iascone, M. Merlo, M. Triggiani, R. Lorusso, P. Herijgers, J. J. Schreuder, S. Pentiricci, A. Iacovoni, et al.
Implantation of an Elastic Ring at Equator of the Left Ventricle Influences Cardiac Mechanics in Experimental Acute Ventricular Dysfunction
J. Am. Coll. Cardiol., October 30, 2007; 50(18): 1791 - 1798.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. L. Mann, M. A. Acker, M. Jessup, H. N. Sabbah, R. C. Starling, and S. H. Kubo
Clinical Evaluation of the CorCap Cardiac Support Device in Patients With Dilated Cardiomyopathy
Ann. Thorac. Surg., October 1, 2007; 84(4): 1226 - 1235.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. C. Starling, M. Jessup, J. K. Oh, H. N. Sabbah, M. A. Acker, D. L. Mann, and S. H. Kubo
Sustained Benefits of the CorCap Cardiac Support Device on Left Ventricular Remodeling: Three Year Follow-up Results From the Acorn Clinical Trial
Ann. Thorac. Surg., October 1, 2007; 84(4): 1236 - 1242.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
R. K. Ghanta, A. Rangaraj, R. Umakanthan, L. Lee, R. G. Laurence, J. A. Fox, R. M. Bolman III, L. H. Cohn, and F. Y. Chen
Adjustable, Physiological Ventricular Restraint Improves Left Ventricular Mechanics and Reduces Dilatation in an Ovine Model of Chronic Heart Failure
Circulation, March 13, 2007; 115(10): 1201 - 1210.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
I. George, Y. Cheng, G.-H. Yi, K.-L. He, X. Li, M. C. Oz, J. Holmes, and J. Wang
Effect of passive cardiac containment on ventricular synchrony and cardiac function in awake dogs
Eur. J. Cardiothorac. Surg., January 1, 2007; 31(1): 55 - 64.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
K. L. Christman and R. J. Lee
Biomaterials for the Treatment of Myocardial Infarction
J. Am. Coll. Cardiol., September 5, 2006; 48(5): 907 - 913.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. Burkhoff and A. S. Wechsler
Surgical ventricular remodeling: A balancing act on systolic and diastolic properties.
J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 459 - 463.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. A. Acker, S. Bolling, R. Shemin, J. Kirklin, J. K. Oh, D. L. Mann, M. Jessup, H. N. Sabbah, R. C. Starling, S. H. Kubo, et al.
Mitral valve surgery in heart failure: Insights from the Acorn Clinical Trial.
J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 568 - 577.e4.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
A. Cheng, T. C. Nguyen, M. Malinowski, F. Langer, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller
Passive Ventricular Constraint Prevents Transmural Shear Strain Progression in Left Ventricle Remodeling
Circulation, July 4, 2006; 114(1_suppl): I-79 - I-86.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. Feindt, U. Boeken, J.D. Schipke, J. Litmathe, N. Zimmermann, and E. Gams
Ventricular constraint in dilated cardiomyopathy: A new, compliant textile mesh exerts prophylactic and therapeutic properties
J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1107 - 1107.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
D. Mancini and D. Burkhoff
Mechanical Device-Based Methods of Managing and Treating Heart Failure
Circulation, July 19, 2005; 112(3): 438 - 448.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
E. Monnet and J. C. Chachques
Animal Models of Heart Failure: What Is New?
Ann. Thorac. Surg., April 1, 2005; 79(4): 1445 - 1453.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
F. A. Tibayan, F. Rodriguez, F. Langer, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller
Undersized Mitral Annuloplasty Alters Left Ventricular Shape During Acute Ischemic Mitral Regurgitation
Circulation, September 14, 2004; 110(11_suppl_1): II-98 - II-102.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Lembcke, S. Dushe, S. Sonntag, C. Kloeters, C. N. H. Enzweiler, T. H. Wiese, B. Hamm, F.-X. Kleber, and W. F. Konertz
Changes in right ventricular dimensions and performance after passive cardiac containment
Ann. Thorac. Surg., September 1, 2004; 78(3): 900 - 905.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. Lembcke, S. Dushe, C. N.H. Enzweiler, C. Kloeters, T. H. Wiese, K.-G. A. Hermann, B. Hamm, and W. F. Konertz
Passive external cardiac constraint improves segmental left ventricular wall motion and reduces akinetic area in patients with non-ischemic dilated cardiomyopathy
Eur. J. Cardiothorac. Surg., January 1, 2004; 25(1): 84 - 90.
[Abstract] [Full Text] [PDF]

Home page
 Circ. Res.Home page
K. B. Margulies
Blocking Stretch-Induced Myocardial Remodeling
Circ. Res., November 28, 2003; 93(11): 1020 - 1022.
[Full Text] [PDF]

Home page
 Circ. Res.Home page
H. N. Sabbah, V. G. Sharov, R. C. Gupta, S. Mishra, S. Rastogi, A. I. Undrovinas, P. A. Chaudhry, A. Todor, T. Mishima, E. J. Tanhehco, et al.
Reversal of Chronic Molecular and Cellular Abnormalities Due to Heart Failure by Passive Mechanical Ventricular Containment
Circ. Res., November 28, 2003; 93(11): 1095 - 1101.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. C. Oz, W. F. Konertz, F. X. Kleber, F. W. Mohr, J. F. Gummert, J. Ostermeyer, M. Lass, J. Raman, M. A. Acker, and N. Smedira
Global surgical experience with the Acorn cardiac support device
J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 983 - 991.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. S. Raman, M. J. Byrne, J. M. Power, and C. A. Alferness
Ventricular constraint in severe heart failure halts decline in cardiovascular function associated with experimental dilated cardiomyopathy
Ann. Thorac. Surg., July 1, 2003; 76(1): 141 - 147.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. N. Sabbah
The cardiac support device and the Myosplint: treating heart failure by targeting left ventricular size and shape
Ann. Thorac. Surg., June 1, 2003; 75(90060): S13 - 19.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. Shabetai
Monitoring heart failure hemodynamics with an implanted device:its potential to improve outcome
J. Am. Coll. Cardiol., February 19, 2003; 41(4): 572 - 573.
[Full Text] [PDF]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2002 by the American College of Cardiology Foundation.