After a Cardiomyoplasty, Collaterals from Skeletal Muscle Form to Chronic Ischemic Myocardium

Abstract

We measured the collateral formation between skeletal muscle and the heart after a latissimus dorsi cardiomyoplasty in an animal model that contained normal, chronic ischemic, and infarcted myocardium. The area at risk for ischemia was 27.0 +/- 3.2% of the left ventricular mass (n = 10, mean +/- SE). In five animals the risk area developed predominantly into chronic ischemic myocardium; in five others the risk area became an infarct. The collateral blood flow from the skeletal muscle to chronic ischemic myocardium (6.05 +/- 1.36 ml/100 g/min, n = 5) was higher than flow to the infarct (0.46 +/- 0.31 ml/100 g/min, n = 5). The collateral blood flow to normal myocardium was minimal (0.04 +/- 0.01 ml/100 g/min). The collateral blood flow appeared to be concentrated in the outer half of the left ventricular wall, with the epicardium having a higher skeletal muscle derived collateral blood flow than endocardium (p < 0.05). We conclude that after a cardiomyoplasty a collateral blood flow, which approaches clinical significance, is preferentially established between skeletal muscle and chronic ischemic myocardium. Enhancement of this collateral blood flow might provide a means to revascularize patients with presently inoperable coronary disease.

Heparin and Basic Fibroblast Growth Factor Are Associated with Preservation of Latissimus Cardiomyoplasties in Goats: A Retrospective Study

“…Each animal underwent a left latissimus dorsi cardiomyoplasty under general anesthesia as described by Bailey et al4 Seven animals received no further treatment (O-Hz group). 7 Five animals received chronic 2-Hz electrical stimulation of the thoracodorsal nerve (2-Hz group)4 via an implantable neurostimulator (Itrel Model 7421, Medtronics, Inc., Minneapolis, MN, USA).…”

Adynamic Cardiomyoplasty: Effect on Cardiac Efficiency and Contractile Reserve in Dogs with Adriamycin-Induced Cardiomyopathy

“…Skeletal muscle might also have a trophic effect to the myocardium by establishing vascular connection with the myocardium. 21 A skeletal muscle flap without electrical stimulation loses some strength and become more compliant.22 Chronic electrical stimulation of the skeletal muscle might provide some tonicity to the wrap that allows a better support for myocardium during systole.…”