PubMedDate not supplied
BACKGROUND: Wrapping around the heart (static cardiomyoplasty) may help prevent a failing left ventricle (LV) from dilatation but may also interfere with diastolic relaxation, resulting in restrictive hemodynamics and diastolic heart failure. We developed a synthetic net with a dual elasticity and tested its effect early after induced myocardial infarction (MI) in the rat. METHODS: In rats undergoing occlusion of the left anterior descending artery (LAD) with and without cardiac wrapping, pressure-volume (PV) relationships were successively analyzed before, after intravenous volume load (saline 1% of body weight over 30 sec), and 10 to 40 minutes after LAD occlusion. In each situation, end-diastolic and end-systolic PV relationships were defined and LV size and function compared under standardized loading conditions. RESULTS: Ischemic increase in LV end-diastolic and end-systolic volumes was suppressed in a similar magnitude in NET with rats, resulting in preserved stroke volume and ejection fraction early after MI. While the presence of the net yielded a significant hemodynamic difference in response to acute volume load before ischemia, the difference was no longer apparent in the ischemic heart after LAD ligation. CONCLUSION: Static cardiomyoplasty using a synthetic elastic net significantly suppresses ischemic LV dilatation and dysfunction without restriction immediately after MI in the rat. The long-term result is pending. Net material and elasticity needs to be adjusted for optimal girdling effect, or greatest benefits with least functional compromise.