Preservation of left ventricular function and morphology in volume-loaded versus volume-unloaded heterotopic heart transplants

TY - JOUR

T1 - Preservation of left ventricular function and morphology in volume-loaded versus volume-unloaded heterotopic heart transplants

AU - Didié, Michael

AU - Biermann, Daniel

AU - Buchert, Ralph

AU - Hess, Andreas

AU - Wittköpper, Katrin

AU - Christalla, Peter

AU - Döker, Stephan

AU - Jebran, Fawad

AU - Schöndube, Friedrich

AU - Reichenspurner, Hermann

AU - El-Armouche, Ali

AU - Zimmermann, Wolfram-Hubertus

PY - 2013/8/15

Y1 - 2013/8/15

N2 - Total mechanical unloading of the heart in classical models of heterotopic heart transplantation leads to cardiac atrophy and functional deterioration. In contrast, partial unloading of failing human hearts with left ventricular (LV) assist devices (LVADs) can in some patients ameliorate heart failure symptoms. Here we tested in heterotopic rat heart transplant models whether partial volume-loading (VL; anastomoses: aorta of donor to aorta of recipient, pulmonary artery of donor to left atrium of donor, superior vena cava of donor to inferior vena cava of recipient; n = 27) is superior to the classical model of myocardial unloading (UL; anastomoses: aorta of donor to aorta of recipient, pulmonary artery of donor to inferior vena cava of recipient; n = 14) with respect to preservation of ventricular morphology and function. Echocardiography, magnetic resonance imaging, and LV-pressure-volume catheter revealed attenuated myocardial atrophy with ~30% higher LV weight and better systolic contractile function in VL compared with UL (fractional area shortening, 34% vs. 18%; maximal change in pressure over time, 2,986 ± 252 vs. 2,032 ± 193 mmHg/s). Interestingly, no differences in fibrosis (Picrosirus red staining) or glucose metabolism (2-[18F]-fluoro-2-deoxy-D-glucose-PET) between VL and UL were observed. We conclude that the rat model of partial VL attenuates atrophic remodelling and shows superior morphological as well as functional preservation, and thus should be considered more widely as a research model.

AB - Total mechanical unloading of the heart in classical models of heterotopic heart transplantation leads to cardiac atrophy and functional deterioration. In contrast, partial unloading of failing human hearts with left ventricular (LV) assist devices (LVADs) can in some patients ameliorate heart failure symptoms. Here we tested in heterotopic rat heart transplant models whether partial volume-loading (VL; anastomoses: aorta of donor to aorta of recipient, pulmonary artery of donor to left atrium of donor, superior vena cava of donor to inferior vena cava of recipient; n = 27) is superior to the classical model of myocardial unloading (UL; anastomoses: aorta of donor to aorta of recipient, pulmonary artery of donor to inferior vena cava of recipient; n = 14) with respect to preservation of ventricular morphology and function. Echocardiography, magnetic resonance imaging, and LV-pressure-volume catheter revealed attenuated myocardial atrophy with ~30% higher LV weight and better systolic contractile function in VL compared with UL (fractional area shortening, 34% vs. 18%; maximal change in pressure over time, 2,986 ± 252 vs. 2,032 ± 193 mmHg/s). Interestingly, no differences in fibrosis (Picrosirus red staining) or glucose metabolism (2-[18F]-fluoro-2-deoxy-D-glucose-PET) between VL and UL were observed. We conclude that the rat model of partial VL attenuates atrophic remodelling and shows superior morphological as well as functional preservation, and thus should be considered more widely as a research model.

KW - Anastomosis, Surgical

KW - Animals

KW - Aorta/physiopathology

KW - Atrophy

KW - Cardiac Catheterization

KW - Echocardiography

KW - Fibrosis

KW - Heart Transplantation/adverse effects

KW - Heart-Assist Devices

KW - Hemodynamics

KW - Magnetic Resonance Imaging

KW - Male

KW - Models, Animal

KW - Myocardial Contraction

KW - Positron-Emission Tomography

KW - Pulmonary Artery/physiopathology

KW - Rats

KW - Rats, Wistar

KW - Time Factors

KW - Vena Cava, Inferior/physiopathology

KW - Vena Cava, Superior/physiopathology

KW - Ventricular Dysfunction, Left/diagnosis

KW - Ventricular Function, Left

KW - Ventricular Pressure

KW - Ventricular Remodeling

U2 - 10.1152/ajpheart.00218.2013

DO - 10.1152/ajpheart.00218.2013

M3 - SCORING: Journal article

C2 - 23771692

VL - 305

SP - 533

EP - 541

JO - AM J PHYSIOL-HEART C

JF - AM J PHYSIOL-HEART C

SN - 0363-6135

IS - 4

ER -