Badania kliniczne i doświadczalne w chorobach serca, płuc i naczyń
The experimental model of the congestive heart failure

Congestive heart failure (CHF) currently affects over 5 million people in the United States with heart transplantation as the only clinically effective therapy. Organ shortage and transplant program restrictions on organ recipient age translate into increased mortality secondary to progressive CHF. A recent alternative to complete organ transplantation has been the concept of cellular transplantation. Our laboratory has an established ovine model of chronic ischemic CHF produced by serial coronary artery microembolizations. This particular ovine model closely resembles human CHF for two important reasons: first, the similarities between sheep and human coronary anatomy; and secondly because of similarities in the microembolization process itself with the actual progression of ischemic heart disease in people. This model produces stable heart failure that we have documented beyond one year (see Tab. I and Fig. 3.). Using accepted coronary angiographic techniques, selective left circumflex coronary artery (LCx) microembolizations are performed with 0.5cc of 90-micron polystyrene beads. Sheep undergo weekly echocardiograms to assess ejection fraction LVEF, LVEDA and LVESA. LCx embolizations are repeated until LVEF <35% is achieved for two consecutive weeks. This model of heart failure mimics human ischemic dilated CHF by producing a reduction in cardiac contractile function resulting over time in a dilated and remodeled ventricle. The distinct transition will allow for intervention after ischemic insult at two critical points: either before or after ventricular dilatation occurs. Technologies exist and are routinely used in our laboratory for the acute and chronic analysis of cardiac function.