Anisotropic Reinforcement to Improve Post-Infarction LV Function

各向异性强化可改善梗塞后左心室功能

• 批准号: 8403788
• 负责人: JEFFREY W HOLMES
• 金额: $ 17.87万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-01-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8403788
• 关键词: Acute; Address; Adrenergic beta-Antagonists; Affect; American; Angioplasty; Angiotensin-Converting Enzyme Inhibitors; Animal Model; Animals; Anisotropy; Anterior; Area; Canis familiaris; Cardiology; Cicatrix; Clinical; Computer Simulation; Coronary artery; Data; Deterioration; Development; Fibrinolytic Agents; Goals; Healed; Health; Heart; Heart failure; Hour; Infarction; Lead; Left; Left Ventricular Function; Left Ventricular Remodeling; Location; Mechanics; Mental Depression; Methods; Muscle; Myocardial Infarction; Myocardium; Natural regeneration; Patients; Pattern; Pharmaceutical Preparations; Preparation; Property; Psychological reinforcement; Pump; Recurrence; Risk; Role; Shapes; Stents; Testing; Therapeutic; Tissues; Ventricular; Ventricular Function; Woman; Work; base; blood pump; clinical application; experience; follow-up; healing; heart dimension/size; heart function; improved; innovation; men; novel; older patient; prevent; research study

Over a million Americans experience a myocardial infarction (heart attack) each year. Following a heart attack, damaged heart muscle cannot regenerate; instead, it is gradually replaced by scar tissue over the course of several weeks. The loss of heart muscle reduces the ability of the heart to pump blood, and in many cases this triggers a gradual decline in heart function and alterations in heart size and shape (remodeling) that ultimately lead to heart failure. Although drugs such as angiotensin converting enzyme (ACE) inhibitors can help reduce post-infarction remodeling, the risk of developing heart failure after surviving a heart attack remains high. Because the mechanical properties of the scar tissue that forms after a heart attack are critical determinants of both heart function and the eventual transition to heart failure, several new therapies under development attempt to modify the mechanical properties of that scar in order to reduce left ventricular (LV) remodeling, improve pump function, or both. Recent computer modeling and experimental studies suggest that infarcts that are very stiff in one direction but relatively soft in others (mechanically anisotropic) should provide the best heart function. This proposal focuses on a novel method to create mechanical anisotropy by surgically reinforcing the infarct. Based on preliminary data showing that anisotropic reinforcement dramatically improves pump function immediately after a heart attack, this project will test the hypothesis that anisotropic reinforcement reduces LV remodeling and functional deterioration over the first 2 months folowing myocardial infarction in a large animal model. New computational modeling studies will also determine whether infarcts in different locations require diferent patterns of mechanical reinforcement to optimize LV function.

每年有超过一百万的美国人经历心肌梗塞（心脏病）。跟随心 攻击，心肌受损无法再生；相反，它逐渐被疤痕组织所取代 几周的过程。心肌失去会降低心脏泵血的能力， 在许多情况下，这会触发心脏功能逐渐下降和心脏大小的改变和 最终导致心力衰竭的形状（重塑）。虽然血管紧张素转化等药物 酶（ACE）抑制剂可以帮助减少结构后重塑，患心力衰竭的风险 生存后，心脏病发作仍然很高。因为疤痕组织的机械性能 心脏病发作后的形式是心脏功能和最终过渡到的关键决定因素 心力衰竭，正在开发的几种新疗法试图修改机械性能 为了减少左心室（LV）重塑，改善泵功能或两者兼而有之。最近的 计算机建模和实验研究表明，梗塞在一个方向上非常僵硬但 其他相对较软（机械上各向异性）应提供最佳的心脏功能。这个建议 专注于一种新的方法来通过手术加强梗塞来创建机械各向异性。基于 关于初步数据，表明各向异性增强大大改善了泵功能 心脏病发作后，该项目立即检验了各向异性增强的假设 在最初的两个月内减少LV重塑和功能恶化 大型动物模型中的梗塞。新的计算建模研究还将确定是否 不同位置的梗塞需要机械加固的不同模式才能优化LV 功能。