Critical single proximal left arterial descending coronary artery stenosis to mimic chronic myocardial ischemia: a new model induced by minimal invasive technology

J Vasc Res. 2009;46(4):290-8. doi: 10.1159/000181545. Epub 2008 Dec 11.

Abstract

Background/aims: 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.

Conclusion: The presented experimental model mimics the clinical situation of chronic myocardial ischemia secondary to 1-vessel coronary disease.

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / instrumentation
  • Animals
  • Chronic Disease
  • Collateral Circulation
  • Coronary Angiography
  • Coronary Circulation
  • Coronary Stenosis / complications*
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / etiology
  • Coronary Stenosis / physiopathology
  • Coronary Vessels / pathology
  • Coronary Vessels / physiopathology*
  • Critical Illness
  • Disease Models, Animal*
  • Echocardiography, Stress
  • Female
  • Fibrosis
  • Male
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / etiology*
  • Myocardial Ischemia / physiopathology
  • Positron-Emission Tomography
  • Severity of Illness Index
  • Stents / adverse effects*
  • Stroke Volume
  • Swine
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology