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CardioClasp changes left ventricular shape acutely in enlarged canine heart
Abul Kashem1, William P Santamore, Sarmina Hassan
1Cardiovascular Research, Temple University, Philadelphia, Pennsylvania, USA. mkashem@temple.edu
Journal of Cardiac Surgery
|August 22, 2003
Summary
The CardioClasp device reshapes the left ventricle (LV) to reduce heart wall stress and improve systolic function in dilated cardiomyopathy (DCM). This novel approach enhances cardiac contractility without negatively impacting blood pressure.
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Heart Failure Treatment
Background:
- Dilated cardiomyopathy (DCM) involves increased myocardial cell burden, leading to elevated left ventricular wall stress (LVWS) and reduced systolic performance.
- Reducing this extra-geometric burden is a key therapeutic strategy for improving cardiac function.
- The CardioClasp device is a novel, non-blood-contacting technology designed to reshape the left ventricle (LV).
Purpose of the Study:
- To evaluate the efficacy of the CardioClasp device in reducing LV wall stress (LVWS) and improving LV systolic function and contractility.
- To determine if CardioClasp can reshape the LV without compromising arterial blood pressure or contractile mass.
- To assess the impact of CardioClasp on key hemodynamic and echocardiographic parameters in a canine model of DCM.
Main Methods:
- DCM was induced in mongrel dogs (n=5) via 4 weeks of right ventricular pacing.
- The CardioClasp device was implanted to reshape the LV.
- Hemodynamics, echocardiography, and sonometric crystal data were used to evaluate LV performance, including LV end-systolic pressure-segment length relationships (ESPSR) and end-systolic pressure-area relationships (ESPAR).
Main Results:
- CardioClasp significantly reduced LV end-diastolic dimensions (15% and 25%) and LVWS (from 93.1 to 59.1 g/cm²).
- Fractional area of contraction (FAC) increased significantly (from 27.6% to 33.1%).
- Slopes of ESPSR and ESPAR significantly increased, indicating enhanced contractility, with no significant changes in peak pressures, cardiac output, or LV +dP/dt and -dP/dt.
Conclusions:
- The CardioClasp device effectively reduces LV diameter, decreasing LVWS and enhancing FAC.
- LV reshaping by CardioClasp increases ESPSR and ESPAR slopes, signifying improved contractility.
- The device improves cardiac function and contractility while maintaining systolic pressures and cardiac output.