Basic Science and Experimental StudiesLeft Atrial Reverse Remodeling in Dogs With Moderate and Advanced Heart Failure Treated With a Passive Mechanical Containment Device: An Echocardiographic Study
Section snippets
Experimental Model
The canine model of chronic HF used in this study was previously described in detail.19 Chronic LV dysfunction was produced by multiple sequential coronary microembolizations with polystyrene Latex microspheres (70 to 102 μm in diameter), which result in loss of viable myocardium. The model manifests many of the hemodynamic and neurohormonal sequelae of HF observed in humans including marked and progressive depression of LV systolic and diastolic function, reduced cardiac output, and increased
Results
All dogs entered into the study had baseline angiographic and echocardiographic measures within the range of normality for mongrel dogs in our laboratory. Baseline echocardiographic data for both study groups are shown in Table 1. There were no significant differences in any of the echocardiographic measures obtained at baseline between control dogs and dogs subsequently treated with the CSD. Similarly, there were no significant differences in echocardiographic measure at pretreatment between
LA Reverse Remodeling with CSD Therapy
The present study demonstrates that implantation of the Acorn CSD is effective in preventing LA enlargement and in improving LA mechanical performance in dogs with moderate and advanced HF. This observation is particularly reassuring because the CSD operates by containing the ventricles and preventing progressive LV dilation with no readily apparent theoretical evidence that such a device would favorably affect progressive LA remodeling. The beneficial effects of the CSD on LA remodeling was
Conclusions
The results of the present study indicate chronic CSD therapy, in addition to improving LV function and preventing progressive LV remodeling, also afford considerable benefits on LA function and remodeling. The benefits of CSD therapy on LA function and chamber remodeling appears to be present regardless of the severity of LV dysfunction and, hence severity of HF. The extent to which such benefits of CSD therapy on LA remodeling can lead to reduced risk of adverse cardiovascular events and
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Supported, in part, by grants from Acorn Cardiovascular, Inc., and by a grant from the National Heart, Lung, and Blood Institute, PO1-HL074237-04.