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Jia H, Chang Y, Song J. The pig as an optimal animal model for cardiovascular research. Lab Anim (NY) 2024; 53:136-147. [PMID: 38773343 DOI: 10.1038/s41684-024-01377-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 04/22/2024] [Indexed: 05/23/2024]
Abstract
Cardiovascular disease is a worldwide health problem and a leading cause of morbidity and mortality. Preclinical cardiovascular research using animals is needed to explore potential targets and therapeutic options. Compared with rodents, pigs have many advantages, with their anatomy, physiology, metabolism and immune system being more similar to humans. Here we present an overview of the available pig models for cardiovascular diseases, discuss their advantages over other models and propose the concept of standardized models to improve translation to the clinical setting and control research costs.
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Affiliation(s)
- Hao Jia
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Chang
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiangping Song
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- Sanya Institute of China Agricultural University, Sanya, China.
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2
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Hørsdal OK, Moeslund N, Berg-Hansen K, Nielsen R, Møller N, Eiskjær H, Wiggers H, Gopalasingam N. Lactate infusion elevates cardiac output through increased heart rate and decreased vascular resistance: a randomised, blinded, crossover trial in a healthy porcine model. J Transl Med 2024; 22:285. [PMID: 38493167 PMCID: PMC10943846 DOI: 10.1186/s12967-024-05064-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Lactate is traditionally recognized as a by-product of anaerobic metabolism. However, lactate is a preferred oxidative substrate for stressed myocardium. Exogenous lactate infusion increases cardiac output (CO). The exact mechanism underlying this mechanism has yet to be elucidated. The aim of this study was to investigate the cardiovascular mechanisms underlying the acute haemodynamic effects of exogenous lactate infusion in an experimental model of human-sized pigs. METHODS In this randomised, blinded crossover study in eight 60-kg-pigs, the pigs received infusions with one molar sodium lactate and a control infusion of tonicity matched hypertonic saline in random order. We measured CO and pulmonary pressures using a pulmonary artery catheter. A pressure-volume admittance catheter in the left ventricle was used to measure contractility, afterload, preload and work-related parameters. RESULTS Lactate infusion increased circulating lactate levels by 9.9 mmol/L (95% confidence interval (CI) 9.1 to 11.0) and CO by 2.0 L/min (95% CI 1.2 to 2.7). Afterload decreased as arterial elastance fell by -1.0 mmHg/ml (95% CI -2.0 to -0.1) and systemic vascular resistance decreased by -548 dynes/s/cm5 (95% CI -261 to -835). Mixed venous saturation increased by 11 percentage points (95% CI 6 to 16), whereas ejection fraction increased by 16.0 percentage points (95% CI 1.1 to 32.0) and heart rate by 21 bpm (95% CI 8 to 33). No significant changes in contractility nor preload were observed. CONCLUSION Lactate infusion increased cardiac output by increasing heart rate and lowering afterload. No differences were observed in left ventricular contractility or preload. Lactate holds potential as a treatment in situations with lowered CO and should be investigated in future clinical studies.
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Affiliation(s)
- Oskar Kjærgaard Hørsdal
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Niels Moeslund
- Department of Heart, Lung, and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Kristoffer Berg-Hansen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Roni Nielsen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Niels Møller
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Eiskjær
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henrik Wiggers
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nigopan Gopalasingam
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Department of Cardiology, Gødstrup Hospital, Herning, Denmark.
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Mohl W, Kiseleva Z, Jusic A, Bruckner M, Mader RM. Signs and signals limiting myocardial damage using PICSO: a scoping review decoding paradigm shifts toward a new encounter. Front Cardiovasc Med 2023; 10:1030842. [PMID: 37229230 PMCID: PMC10204926 DOI: 10.3389/fcvm.2023.1030842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/14/2023] [Indexed: 05/27/2023] Open
Abstract
Background Inducing recovery in myocardial ischemia is limited to a timely reopening of infarct vessels and clearing the cardiac microcirculation, but additional molecular factors may impact recovery. Objective In this scoping review, we identify the paradigm shifts decoding the branching points of experimental and clinical evidence of pressure-controlled intermittent coronary sinus occlusion (PICSO), focusing on myocardial salvage and molecular implications on infarct healing and repair. Design The reporting of evidence was structured chronologically, describing the evolution of the concept from mainstream research to core findings dictating a paradigm change. All data reported in this scoping review are based on published data, but new evaluations are also included. Results Previous findings relate hemodynamic PICSO effects clearing reperfused microcirculation to myocardial salvage. The activation of venous endothelium opened a new avenue for understanding PICSO. A flow-sensitive signaling molecule, miR-145-5p, showed a five-fold increase in porcine myocardium subjected to PICSO.Verifying our theory of "embryonic recall," an upregulation of miR-19b and miR-101 significantly correlates to the time of pressure increase in cardiac veins during PICSO (r2 = 0.90, p < 0.05; r2 = 0.98, p < 0.03), suggesting a flow- and pressure-dependent secretion of signaling molecules into the coronary circulation. Furthermore, cardiomyocyte proliferation by miR-19b and the protective role of miR-101 against remodeling show another potential interaction of PICSO in myocardial healing. Conclusion Molecular signaling during PICSO may contribute to retroperfusion toward deprived myocardium and clearing the reperfused cardiac microcirculation. A burst of specific miRNA reiterating embryonic molecular pathways may play a role in targeting myocardial jeopardy and will be an essential therapeutic contribution in limiting infarcts in recovering patients.
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Affiliation(s)
- Werner Mohl
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Zlata Kiseleva
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Alem Jusic
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Matthäus Bruckner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Robert M. Mader
- Department of Medicine I, Comprehensive Cancer Center of the Medical University of Vienna, Vienna,Austria
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4
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The Sheep as a Large Animal Model for the Investigation and Treatment of Human Disorders. BIOLOGY 2022; 11:biology11091251. [PMID: 36138730 PMCID: PMC9495394 DOI: 10.3390/biology11091251] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 12/19/2022]
Abstract
Simple Summary We review the value of large animal models for improving the translation of biomedical research for human application, focusing primarily on sheep. Abstract An essential aim of biomedical research is to translate basic science information obtained from preclinical research using small and large animal models into clinical practice for the benefit of humans. Research on rodent models has enhanced our understanding of complex pathophysiology, thus providing potential translational pathways. However, the success of translating drugs from pre-clinical to clinical therapy has been poor, partly due to the choice of experimental model. The sheep model, in particular, is being increasingly applied to the field of biomedical research and is arguably one of the most influential models of human organ systems. It has provided essential tools and insights into cardiovascular disorder, orthopaedic examination, reproduction, gene therapy, and new insights into neurodegenerative research. Unlike the widely adopted rodent model, the use of the sheep model has an advantage over improving neuroscientific translation, in particular due to its large body size, gyrencephalic brain, long lifespan, more extended gestation period, and similarities in neuroanatomical structures to humans. This review aims to summarise the current status of sheep to model various human diseases and enable researchers to make informed decisions when considering sheep as a human biomedical model.
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Lossi L. Anatomical features for an adequate choice of the experimental animal model in biomedicine: III. Ferret, goat, sheep, and horse. Ann Anat 2022; 244:151978. [PMID: 35787443 DOI: 10.1016/j.aanat.2022.151978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
The anatomical characteristics of each of the many species today employed in biomedical research are very important when selecting the correct animal model(s), especially for conducting translational research. In previous papers, these features have been considered for fish (D'Angelo et al. Ann. Anat, 2016, 205:75), the most common laboratory rodents, rabbits, and pigs (Lossi et al. 2016). I here follow this line of discussion by dealing with the importance of proper knowledge of ferrets, goats, sheep, and horses' main anatomical features in translational research.
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Affiliation(s)
- Laura Lossi
- University of Turin, Department of Veterinary Sciences, Turin, Italy; INN, Istituto Nazionale di Neuroscienze, Turin, Italy.
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6
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Noreen S, Ben-Tal A, Elstad M, Sweatman WL, Ramchandra R, Paton J. Mathematical modelling of atrial and ventricular pressure-volume dynamics and their change with heart rate. Math Biosci 2021; 344:108766. [PMID: 34919936 DOI: 10.1016/j.mbs.2021.108766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 10/22/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022]
Abstract
This paper presents mathematical models that can simulate the cardiovascular system of a healthy sheep under normal resting conditions in which the heart rate changes significantly. The models include several new modelling features that are introduced progressively. The contraction of the cardiac chambers is modelled using a time-dependent muscle force with constant elasticity instead of time dependent elasticity. A new hypothesis about the mechanical contraction of the atria generates realistic pressure volume (PV) loops. The inter-ventricular interaction is modelled as well. Additionally, hysteresis is incorporated in the aortic valve to produce an end-systolic reverse (negative) flow. Most of the model parameter values are based on previous literature data while time periods of delay, atrial and ventricular contraction are derived using experimental data from 14 sheep. We provide new relationships between contraction time and delay as a function of heart period. The effects of different aspects of our modelling on the mean cardiac output, stroke volume, ejection time, ejection fraction and PV loops are studied. Model outputs are compared with published experimental results where possible, and are within a wide range of physiological observations.
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Affiliation(s)
- Shumaila Noreen
- School of Natural and Computational Sciences, Massey University, New Zealand
| | - Alona Ben-Tal
- School of Natural and Computational Sciences, Massey University, New Zealand.
| | - Maja Elstad
- Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Winston L Sweatman
- School of Natural and Computational Sciences, Massey University, New Zealand
| | | | - Julian Paton
- Department of Physiology, University of Auckland, New Zealand
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Góes AMDO, Chaves RHDF, Furlaneto IP, Rodrigues EDM, de Albuquerque FBA, Smit JHA, de Oliveira CP, Abib SDCV. Comparative angiotomographic study of swine vascular anatomy: contributions to research and training models in vascular and endovascular surgery. J Vasc Bras 2021; 20:e20200086. [PMID: 34093675 PMCID: PMC8147709 DOI: 10.1590/1677-5449.200086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Medium and large animal models allow researchers to evaluate the efficacy and safety of cardiovascular procedures in systems that resemble human anatomy and can be used to simulate scenarios for training purposes. Although porcine models have been used extensively, many physiological and anatomical features remain unknown or only superficially described. Objectives To describe the normal porcine vascular anatomy on computed tomography scans, compare it to human vascular anatomy, and discuss the application of porcine models for open and endovascular procedures. Methods Three male Landrace pigs underwent computed tomography. The vascular anatomy of the neck, thorax, abdomen, and limbs was analyzed and described; relevant similarities and differences between porcine and human vascular anatomies and the implications for vascular procedures in pigs are highlighted. Results The carotid territory, aortic arch, and terminal aorta branches all show marked differences in pigs compared to their human counterparts. Compressions of both left renal and common iliac veins were detected, analogous to those seen in human Nutcracker and May-Thurner syndromes. Vascular measurements (diameters, lengths, and angles) of several different porcine territories are presented. Conclusions The data presented should be useful for planning preclinical trials and basic research and for refining surgical training using porcine models in vascular fields.
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Affiliation(s)
- Adenauer Marinho de Oliveira Góes
- Centro Universitário do Estado do Pará - CESUPA, Curso de Medicina, Belém, PA, Brasil.,Universidade Federal de São Paulo - UNIFESP, Programa de Ciência Cirúrgica Interdisciplinar, São Paulo, SP, Brasil
| | | | | | | | | | | | | | - Simone de Campos Vieira Abib
- Universidade Federal de São Paulo - UNIFESP, Programa de Ciência Cirúrgica Interdisciplinar, São Paulo, SP, Brasil
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8
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Anselme F, Albatat M, Marquié C, Leclercq C, Ritter P, Ollivier JF, Shan N, Ziglio F, Feuerstein D. Exploring a New Systematic Route for Left Ventricular Pacing in Cardiac Resynchronization Therapy. Circ J 2021; 85:283-290. [PMID: 33504741 DOI: 10.1253/circj.cj-20-0266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Frequency and distribution of left ventricular (LV) venous collaterals were studied in vivo to evaluate the ease and feasibility of implanting a new ultra-thin LV quadripolar microlead for cardiac resynchronization therapy (CRT).Methods and Results:Evaluable venograms were analyzed to define the prevalence of venous collaterals (>0.5 mm diameter) between: (1) different LV segments; and (2) different major LV veins in: unselected patients who underwent CRT from 2008 to 2012 at Rouen Hospital, France (retrospective); and CRT patients from the Axone Acute pilot study in 2018 (prospective). In prospective patients with evaluable venograms, LV microlead implantation was attempted. Thirty-six (21/65 retrospective, 15/20 prospective) patients had evaluable venograms with ≥1 visible venous collaterals. Collaterals were found between LV veins in all CRT patients with evaluable venograms. Regionally, prevalence was highest between: the apical inferior and apical lateral (42%); and mid inferior and mid inferolateral (42%) segments. Collateral connections were most prevalent between: the inferior interventricular vein (IIV) and lateral vein (64% [23/36]); and IIV and infero-lateral vein (36% [13/36]). Cross-vein microlead implantation was possible in 18 patients (90%), and single-vein implantation was conducted in the other 2 patients (10%). CONCLUSIONS Venous collaterals were found in vivo between LV veins in all CRT patients with evaluable venograms, making this network an option for accessing multiple LV sites using a single LV microlead.
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9
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Farraha M, Lu J, Trivic I, Barry MA, Chong J, Kumar S, Kizana E. Development of a sheep model of atrioventricular block for the application of novel therapies. PLoS One 2020; 15:e0229092. [PMID: 32040499 PMCID: PMC7010276 DOI: 10.1371/journal.pone.0229092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 01/29/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Sheep have been adopted as a pre-clinical large animal for scientific research as they are good models of cardiac anatomy and physiology, and allow for investigation of pathophysiological processes which occur in the large mammalian heart. There is, however, no defined model of atrioventricular block in sheep to allow for pre-clinical assessment of new cardiac treatment options. We therefore aimed to develop an adult sheep model of atrioventricular block with the focus on future novel applications. Methods and results We utilized six sheep to undergo two procedures each. The first procedure involved implantation of a single chamber pacemaker into the right ventricular apex, for baseline assessment over four weeks. The second procedure involved creating atrioventricular block by radiofrequency ablation of the His bundle, before holding for a further four weeks. Interrogation of pacemakers and electrocardiograms determined the persistence of atrioventricular block during the follow up period. Pacemakers were inserted, and atrioventricular block created in 6 animals using a conventional approach. One animal died following ablation of the His bundle, due to procedural complications. Four unablated sheep were assessed for baseline data over four weeks and showed 5.53 ± 1.28% pacing reliance. Five sheep were assessed over four weeks following His bundle ablation and showed continuous (98.89 ± 0.81%) ventricular pacing attributable to persistent atrioventricular block, with no major complications. Conclusion We have successfully developed, characterized and validated a large animal model of atrioventricular block that is stable and technically feasible in adult sheep. This model will allow for the advancement of novel therapies, including the development of cell and gene-based therapies.
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Affiliation(s)
- Melad Farraha
- Sydney Medical School, The University of Sydney, Australia
- Center for Heart Research, The Westmead Institute for Medical Research, Sydney, Australia
| | - Juntang Lu
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Ivana Trivic
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | | | - James Chong
- Sydney Medical School, The University of Sydney, Australia
- Center for Heart Research, The Westmead Institute for Medical Research, Sydney, Australia
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Saurabh Kumar
- Sydney Medical School, The University of Sydney, Australia
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Eddy Kizana
- Sydney Medical School, The University of Sydney, Australia
- Center for Heart Research, The Westmead Institute for Medical Research, Sydney, Australia
- Department of Cardiology, Westmead Hospital, Sydney, Australia
- * E-mail:
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10
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Tune JD, Goodwill AG, Kiel AM, Baker HE, Bender SB, Merkus D, Duncker DJ. Disentangling the Gordian knot of local metabolic control of coronary blood flow. Am J Physiol Heart Circ Physiol 2019; 318:H11-H24. [PMID: 31702972 DOI: 10.1152/ajpheart.00325.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Recognition that coronary blood flow is tightly coupled with myocardial metabolism has been appreciated for well over half a century. However, exactly how coronary microvascular resistance is tightly coupled with myocardial oxygen consumption (MV̇o2) remains one of the most highly contested mysteries of the coronary circulation to this day. Understanding the mechanisms responsible for local metabolic control of coronary blood flow has been confounded by continued debate regarding both anticipated experimental outcomes and data interpretation. For a number of years, coronary venous Po2 has been generally accepted as a measure of myocardial tissue oxygenation and thus the classically proposed error signal for the generation of vasodilator metabolites in the heart. However, interpretation of changes in coronary venous Po2 relative to MV̇o2 are quite nuanced, inherently circular in nature, and subject to confounding influences that remain largely unaccounted for. The purpose of this review is to highlight difficulties in interpreting the complex interrelationship between key coronary outcome variables and the arguments that emerge from prior studies performed during exercise, hemodilution, hypoxemia, and alterations in perfusion pressure. Furthermore, potential paths forward are proposed to help to facilitate further dialogue and study to ultimately unravel what has become the Gordian knot of the coronary circulation.
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Affiliation(s)
- Johnathan D Tune
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Adam G Goodwill
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Alexander M Kiel
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana
| | - Hana E Baker
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Shawn B Bender
- Biomedical Sciences, University of Missouri, Columbia, Missouri.,Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | - Daphne Merkus
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Cardiovascular Research School Erasmus University Rotterdam, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Walter-Brendel Center of Experimental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,German Centre for Cardiovascular Research, Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Cardiovascular Research School Erasmus University Rotterdam, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Rodenberg EJ, Patel DS, Shirley B, Young BW, Taylor AF, Steidinger HR, Fisher SJ, Patel AN. Catheter-based retrograde coronary sinus infusion is a practical delivery technique for introducing biological molecules into the cardiac system. Catheter Cardiovasc Interv 2019; 94:669-676. [PMID: 30866153 DOI: 10.1002/ccd.28159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/31/2018] [Accepted: 02/06/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To demonstrate coronary sinus (CS) retrograde catheterization as a practicable technique for delivering biologics into the heart. BACKGROUND There are many options to deliver biologics into the heart. However, there is no single optimal technique when considering safety, biologic retention, and reproducibility. Retrograde delivery has the potential to address many of these concerns. This study evaluated retrograde CS infusion of luciferase-expressing plasmid in a porcine model using the Advance® CS Coronary Sinus Infusion Catheter and bioluminescence imaging to track the expression of the infused biological markers. METHODS Plasmid was delivered retrograde into the CS in one of three infusion volumes. Twenty-four hours post-infusion, hearts were excised and underwent bioluminescence imaging to characterize the expression of the infusates. Heart and lung biopsies were also assessed for luciferase expression using RT-qPCR. RESULTS Retrograde infusion was safe and successful in all nine test subjects. Luciferase detection was inconsistent in the low volume group. Bioluminescence was confined predominantly along the posterolateral left ventricle for medium volume infusions and was more broadly dispersed along the anterior side of the heart for high volume infusions. Tissue mRNA analysis corroborated the bioluminescence results, with the highest concentration of luciferase expression localized in the left ventricle. CONCLUSIONS Retrograde CS infusion is a promising technique for delivering biological molecules to the heart. Specifically, this study demonstrated that the low pressure coronary venous system accommodates a wide range of infusion volumes and that biological infusates can be maintained in situ following the resumption of coronary venous flow.
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Affiliation(s)
| | - Dimki S Patel
- Human Therapeutics Division, Intrexon Corporation, Germantown, Maryland
| | - Brad Shirley
- Cook BioDevice, Cook Regentec LLC, Indianapolis, Indiana
| | - Brandt W Young
- Non-Clinical Testing, Cook Research Incorporated, West Lafayette, Indiana
| | - Amanda F Taylor
- Cell Manufacturing Solutions, Cook Regentec LLC, Indianapolis, Indiana
| | | | - Scott J Fisher
- Emerging Therapies, Precigen, Inc., Germantown, Maryland
| | - Amit N Patel
- Division of Cardiothoracic Surgery, University of Miami, Miller School of Medicine, Miami, Florida
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12
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Musil V, Sach J, Patzelt M, Kachlik D, Stingl J. Valves of the small coronary veins in porcine hearts. J Morphol 2019; 280:681-686. [DOI: 10.1002/jmor.20974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/17/2019] [Accepted: 02/16/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Vladimir Musil
- Centre of Scientific Information, Third Faculty of Medicine, Charles University Prague Czech Republic
- Department of AnatomyThird Faculty of Medicine, Charles University Prague Czech Republic
| | - Josef Sach
- Department of Pathology, Third Faculty of MedicineCharles University and Faculty Hospital Kralovske Vinohrady Prague Czech Republic
| | - Matej Patzelt
- Department of AnatomyThird Faculty of Medicine, Charles University Prague Czech Republic
| | - David Kachlik
- Department of AnatomyThird Faculty of Medicine, Charles University Prague Czech Republic
| | - Josef Stingl
- Department of AnatomyThird Faculty of Medicine, Charles University Prague Czech Republic
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