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Eur J Cardiothorac Surg 2003;24:98-104
© 2003 Elsevier Science NL

Reproducible model of post-infarction left ventricular dysfunction: haemodynamic characterization by conductance catheter

^a Academic Department of Cardiac Surgery, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK
^b Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

Received 21 June 2001; received in revised form 31 March 2003; accepted 4 April 2003.

^* Corresponding author. Tel.: +44-20-7351-8533; fax: +44-20-7351-8229
e-mail: m.yacoub{at}ic.ac.uk

Objective: The understanding of pathophysiology and cellular mechanisms of chronic heart failure requires the creation of appropriate and accurately characterized animal models, thus enabling meaningful evaluation of evolving medical and surgical therapies. Methods: The left anterior descending and its diagonal branch were ligated in 12 sheep to induce left ventricular dysfunction. Results: Study of left ventricular pressure–volume loops 3 months post-operatively showed a significant deterioration of both systolic and diastolic indexes of left ventricular function. The left ventricular end-diastolic pressure increased from 3±1 to 7±1 mmHg (P<0.001) along with a substantial increase in end-diastolic volume from 78±8 to 121±6 ml (P=0.002) and a significant decrease in cardiac output from 2±0.2 to 1.5±0.2 l/min (P=0.001). The left ventricular end-systolic pressure–volume relationship deteriorated from 2.7±0.37 to 0.7±0.16 mmHg/ml (P=0.0002) along with a significant reduction in the pre-load recruitable stroke work (P=0.001). The ejection fraction decreased from 34±2% to 16±4% (P<0.001) with a significant decrease in +dp/dt and -dp/dt (P=0.009). The mean systemic blood pressure, however, was maintained due to a substantial increase in the systemic vascular resistance (P=0.007). Conclusion: This study describes a reproducible large animal model of left ventricular dysfunction. This model is potentially useful to study the pathogenesis of remodelling, surgical management of heart failure and development of novel treatment strategies.

Key Words: Sheep • Left ventricle • Ventricular dysfunction • End-systolic pressure–volume relationship • Pre-load recruitable stroke work

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