Ventricular remodeling: Hype or hope?

McCarthy, P.

doi:10.1038/nm0896-859

Cited by 20 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, no outcome data from the patients in the present study are available. McCarthy, 5 Starling et al, 6 and Pashkow 7 have reported preliminary outcome data after PLV in a series of 53 patients, with a 1-year mortality rate of Ϸ6%. However, 20% to 30% of their patients had subsequent worsening of heart failure, with 15% to 20% requiring mechanical circulatory assistance.…”

Section: Selected Abbreviations and Acronymsmentioning

confidence: 98%

“…2,3 Furthermore, patient outcome remains variable, and details concerning patient selection, the surgical technique itself, and long-term outcome are just beginning to emerge. [1][2][3][4][5][6][7] The objectives of this study were (1) to enhance understanding of the immediate effects of PLV on LV performance in patients with severe heart failure by use of relatively load-independent measures and (2) to identify potential clinical or histological variables that may be associated with improvements in LV performance.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Heterogeneous Immediate Effects of Partial Left Ventriculectomy on Cardiac Performance

Gorcsan¹,

Feldman²,

Kormos³

et al. 1998

Circulation

View full text Add to dashboard Cite

Background-Partial left ventriculectomy (PLV) is a novel surgical treatment for severe heart failure consisting of resection of a large wedge of myocardium to reduce wall stress and restore the normal mass-volume ratio. Although ejection fraction (EF) has been shown to improve after PLV, few other physiological data describing its immediate effects on left ventricular (LV) performance are available. Methods and Results-Eight patients, 58Ϯ5 years old, with severe clinical heart failure and EF of 12Ϯ3% were studied before and immediately after PLV. LV performance was assessed by the predominantly load-insensitive measures of pressure-area relations with high-fidelity pressure catheters and transesophageal automated echocardiographic measures of cross-sectional area as a surrogate for volume. LV end-diastolic volume decreased from 200Ϯ60 to 89Ϯ17 mL, EF increased from 12Ϯ3% to 41Ϯ8%, and right ventricular (RV) fractional area change increased from 24Ϯ12% to 37Ϯ16% (all PϽ.05 versus before). Changes in pressure-area relations were variable: end-systolic elastance, 6.5Ϯ3.4 to 4.3Ϯ2.5 mm Hg/cm 2 and preload recruitable stroke work, 33Ϯ16 to 34Ϯ19 mm Hg (PϭNS versus before). End-diastolic stiffness increased from 0.13Ϯ0.06 to 0.19Ϯ0.07 mm Hg/cm 2 (PϽ.05 versus before). Improvement in LV performance was inversely correlated with semiquantitative histological assessment of myocardial fibrosis and positively correlated with nuclear enlargement and hyperchromasia, indicative of myocyte hypertrophy. No long-term follow-up data were available. Conclusions-PLV resulted in reductions in LV volumes, increases in EF and RV ejection, but increases in LV stiffness.Estimates of LV performance revealed variable results associated with the degree of myocardial fibrosis. Further study of these effects in relation to patient outcome is warranted. (Circulation. 1998;97:839-842.)

show abstract

Section: Selected Abbreviations and Acronymsmentioning

confidence: 98%

mentioning

confidence: 99%

Heterogeneous Immediate Effects of Partial Left Ventriculectomy on Cardiac Performance

Gorcsan¹,

Feldman²,

Kormos³

et al. 1998

Circulation

View full text Add to dashboard Cite

show abstract

“…1) Current treatment modalities, such as angioplasty and thrombolytic agents, are far from adequate. [2][3][4] Cardiac tissue engineering is one of the new therapies for myocardial infarction. 5) In native heart tissue, cardiac cells metabolize very actively, and cell density is very high (abut 1.0 × 10 8 /cm 3 ).…”

mentioning

confidence: 99%

Culturing of Ventricle Cells at High Density and Construction of Engineered Cardiac Cell Sheets Without Scaffold

et al. 2009

View full text Add to dashboard Cite

SummaryIn natural heart tissue, cell density is about 1.0 × 10 8 /cm 3 , and the cell metabolism is very active. Therefore, culturing heart cells in 3-dimensions at high density and construction of engineered cardiac tissue in vitro is very difficult. The aim of this study was to simulate 3-dimensional culturing of cardiac cells and pursue a novel method to construct engineered cardiac tissue in vitro. The isolated neonatal rat ventricle cells were cultured at a high seeding density of 1 × 10 6 /cm 2 . The cells at high density metabolized actively;the glucose consumption and lactic acid production of ventricle cells were much greater than those of fibroblasts cultured at the same density. The pH value of the culture medium of ventricle cells consistently decreased more rapidly. These cultured ventricle cells contained vascular endothelial cells, cardiomyocytes, and smooth muscle cells that appeared close to each other, and had overlapping nuclei and plenty of extracellular collagen. The cells at high density were treated with 0.2% trypsin to construct engineered cardiac cell sheets without scaffold. The engineered cardiac cell sheets could beat and roll up spontaneously, each sheet was 3 to 5 cells thick, and contained abundant cardiomyocytes and extracellular collagen.In conclusion, cells cultured at high-density in vitro grew well in a 2-dimensional culturing environment, formed "quasi 3-dimension" culturing, and engineered cardiac cell sheets comprised of several layers of cells were constructed. This study provides some guidance for cardiac tissue engineering and a novel method to construct engineered cardiac tissue without scaffold. (Int Heart J 2009; 50: 653-662)

show abstract

“…The procedure nevertheless carries multiple risks: 20% of patients die while awaiting a donor heart; 10-20% die during the first year after a transplant; and there are ongoing risks of rejection, infection, coronary artery disease, and cancers. 28 The availability of xenografts from transgenic pigs or baboons could reduce the waiting list mortality, but would carry the additional risk of infection by latent animal viruses 3,8 ; the other risks and costs would remain. Ventricular reduction carries a high perioperative mortality and an adequate assessment awaits the outcome of properly conducted clinical trials.…”

mentioning

confidence: 99%

“…Ventricular reduction carries a high perioperative mortality and an adequate assessment awaits the outcome of properly conducted clinical trials. 28 Mechanical artificial hearts will continue to be used mainly as a bridge to transplant; furthermore, even if all the problems of bio-and hemocompatibility were solved, the continuous presence of an external power supply may pose an unacceptable psychological challenge to the patient in long-term use. 37 Against this background, a surgical approach to cardiac assist that is based on the use of a patient's own skeletal muscle is an attractive prospect.…”

mentioning

confidence: 99%

The dose-related response of rabbit fast muscle to long-term low-frequency stimulation

et al. 1998

View full text Add to dashboard Cite

Ventricular remodeling: Hype or hope?

Cited by 20 publications

References 0 publications

Heterogeneous Immediate Effects of Partial Left Ventriculectomy on Cardiac Performance

Heterogeneous Immediate Effects of Partial Left Ventriculectomy on Cardiac Performance

Culturing of Ventricle Cells at High Density and Construction of Engineered Cardiac Cell Sheets Without Scaffold

The dose-related response of rabbit fast muscle to long-term low-frequency stimulation

Contact Info

Product

Resources

About