Evaluation of cardiomyoplasty and skeletal muscle ventricle procedures in a clinically realistic animal model.
Cardiomyoplasty and skeletal muscle ventricle procedures have shown increasing promise in the treatment of cardiomyopathy with associated chronic congestive heart failure. More than 100 patients have now received such procedures worldwide. The clinical results to date have been mostly anecdotal with subjective improvement but without firm objective data to collaborate the subjective impression. A clinically realistic animal model would have tremendous advantages to help elucidate the mechanisms by which cardiomyoplasty or skeletal muscle ventricles improve the sense of well-being of patients who have congestive heart failure. Several possible animal models exist, including pharmacologically induced congestive heart failure models and postischemic injury cardiomyopathy models. The most intriguing, however, is a spontaneously occurring cardiomyopathy in large dogs. This idiopathic cardiomyopathy that appears mainly in large-breed dogs (Great Danes, Dobermans, and Saint Bernards) has a rapidly progressive course; it has a 6-month mortality rate of 75% and a 12-month mortality rate of 95% to 100%. The most efficacious use of such an experimental model would include the evaluation of cardiomyoplasty and skeletal muscle ventricle procedures in a multidimensional fashion. Experimental endpoints should include mortality, exercise tolerance, systolic and diastolic ventricular function, and arrhythmia occurrence. Sophisticated techniques now exist for the evaluation of systolic and diastolic ventricular function. Such evaluation may well provide additional insight into how such experimental procedures benefit those with congestive heart failure.
Kern
K B
KB
Department of Medicine, University of Arizona, College of Medicine, Tucson.
Fenster
P E
PE
D000818:Animals; D001243:Assisted Circulation; D006348:Cardiac Surgical Procedures; D004195:Disease Models, Animal; D005069:Evaluation Studies as Topic; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate; D009132:Muscles / Q000637:transplantation*; D013524:Surgical Flaps; D016277:Ventricular Function, Left