Date on Master's Thesis/Doctoral Dissertation
Koenig, Steven Christopher
Heart failure; mechanical circulatory support; extracellular matrix; regenerative medicine
Heart valve prosthesis; Heart--Left ventricle; Heart, Mechanical
Purpose: Currently, heart transplantation and mechanical circulatory support (MCS) are the preferred treatments for end stage heart failure. However, these therapies are associated with a shortage of donor organs, a 5-yr survival rate of 80%, and adverse events associated with long-term MCS usage. To overcome these limitations, new clinical paradigm is proposed using a combination therapy of MCS and extracellular matrix (ECM) injection therapy to promote myocardial recovery. Methods: The experimental design consisted of a control (no therapy, n=10) and 3 test groups: (1) ECM only (n=2); (2) MSC (HVAD) only (n=2); and (3) HVAD + ECM (n=2) in a 60-day chronic ischemic heart failure (IHF) bovine model. The ECM (CorMatrix®, Atlanta, GA) was injected into the ischemic region of myocardium and the HVAD (HeartWare®, Miami Lakes, FL), a centrifugal continuous flow device was implanted. Cardiovascular efficacy and function were quantified using by serial measurements of hemodynamics, echocardiogram and fluoroscopy imaging, fluorescent microsphere perfusion, and BrdU labeling (myocyte proliferation). vi Results: The study demonstrated HVAD+ECM therapy may provide greatest benefits toward myocardial remodeling and recovery. The preliminary data indicates feasibility in the new treatment method and a larger sample size is needed to determine significance.
Smith, Erin F., "Ventricular assist device and extracellular matrix combination therapy in a chronic ischemic heart failure bovine model." (2013). Electronic Theses and Dissertations. Paper 1351.