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Percutaneous endocardial injection of erythropoietin: Assessment of cardioprotection by electromechanical mapping
Author(s) -
Krause Korff T.,
Jaquet Kai,
Geidel Stephan,
Schneider Carsten,
Mandel Christina,
Stoll HansPeter,
Hertting Klaus,
Harle Tobias,
Kuck KarlHeinz
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.10.017
Subject(s) - medicine , erythropoietin , cardioprotection , cardiology , ejection fraction , ventricle , myocardial infarction , ischemia , perfusion , hibernating myocardium , infarction , revascularization , heart failure
Background: Apart from its well‐known stimulation of erythropoiesis, erythropoietin (EPO) exhibits angiogenic and anti‐apoptotic effects. These cellular protective effects have also been described in experimental acute myocardial infarction models. We investigated the effects of EPO in a porcine model of chronic progressive myocardial ischaemia. Methods At weeks 2 and 6 after implantation of a circumflex ameroid constrictor, endocardial electromechanical NOGA™ system (Biosense Webster, Inc., California, USA) mapping of the left ventricle, coronary and ventricular angiography, as well as echocardiography were performed. Two weeks after ameroid placement, 13 pigs were randomized with 7 pigs receiving 10.000 U EPO and 6 pigs receiving placebo into the ischaemic region using a NOGA™ guided percutaneous transendocardial injection catheter, MYOSTAR™. After 6 weeks, histology (Masson's Trichrome) was analyzed. Results Endocardial electromechanical mapping showed an increase of mean unipolar voltage (UV) amplitude in the ischaemic myocardial segments in the EPO‐treated animals (8.5 mV pre and 10.6 mV post treatment) and a significantly reduced ischaemic surface area compared to the control group (19% vs. 41%) suggesting a decline in ischaemic injury. Echocardiography revealed 2,2 hypokinetic segments of the lateral wall in the EPO group vs. 3,3 in the control groups. The mean ejection fraction was 64% in the EPO group and 55% in the placebo group. Quantitative histological analysis of the ischaemic regions revealed a reduction of myocardial fibrosis (8% vs. 28%) in the EPO group. Conclusion Endocardial EPO injection may induce cardioprotective effects in hibernating myocardium and may attenuate the progression of ischaemic tissue damage.