title: Critical single proximal left arterial descending coronary artery stenosis to mimic chronic myocardial ischemia: a new model induced by minimal invasive technology.
abstract: OBJECTIVE
  The present report examines a new pig model for progressive induction of high-grade stenosis, for the study of chronic myocardial ischemia and the dynamics of collateral vessel growth.
  
  
  METHODS
  Thirty-nine Landrace pigs were instrumented with a novel experimental stent (GVD stent) in the left anterior descending coronary artery. Eight animals underwent transthoracic echocardiography at rest and under low-dose dobutamine. Seven animals were examined by nuclear PET and SPECT analysis. Epi-, mid- and endocardial fibrosis and the numbers of arterial vessels were examined by histology.
  
  
  RESULTS
  Functional analysis showed a significant decrease in global left ventricular ejection fraction (24.5 +/- 1.6%) 3 weeks after implantation. There was a trend to increased left ventricular ejection fraction after low-dose dobutamine stress (36.0 +/- 6.6%) and a significant improvement of the impaired regional anterior wall motion. PET and SPECT imaging documented chronic hibernation. Myocardial fibrosis increased significantly in the ischemic area with a gradient from epi- to endocardial. The number of arterial vessels in the ischemic area increased and coronary angiography showed abundant collateral vessels of Rentrop class 1.
  
  
  CONCLUSIONS
  The presented experimental model mimics the clinical situation of chronic myocardial ischemia secondary to 1-vessel coronary disease.
authors.affiliation: Second Medical Clinic, Johannes Gutenberg University Mainz, Mainz, Germany. horstick@uni-mainz.de
authors.forename: Georg
authors.initials: G
authors.lastname: Horstick
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bierbach
authors.forename: Nico
authors.initials: N
authors.lastname: Abegunewardene
authors.forename: Stefan
authors.initials: S
authors.lastname: Both
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kuhn
authors.forename: Dirk
authors.initials: D
authors.lastname: Manefeld
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Reinecke
authors.forename: Markus
authors.initials: M
authors.lastname: Vosseler
authors.forename: Andreas
authors.initials: A
authors.lastname: Helisch
authors.forename: Dietmar
authors.initials: D
authors.lastname: Becker
authors.forename: Michael
authors.initials: M
authors.lastname: Lauterbach
authors.forename: Oliver
authors.initials: O
authors.lastname: Kempski
authors.forename: Hans-Anton
authors.initials: HA
authors.lastname: Lehr
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D000818:Animals; D002908:Chronic Disease; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology*; D016638:Critical Illness; D004195:Disease Models, Animal; D025401:Echocardiography, Stress; D005260:Female; D005355:Fibrosis; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D049268:Positron-Emission Tomography; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects*; D013318:Stroke Volume; D013552:Swine; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology