Transposition of a pericardial-derived vascular adipose flap for myocardial salvage after infarct

Carolina Gálvez-Montón, Cristina Prat-Vidal, Santiago Roura, Jordi Farré, Carolina Soler-Botija, Aida Llucià-Valldeperas, Idoia Díaz-Güemes, Francisco M Sánchez-Margallo, Alejandro Arís, Antoni Bayes-Genis

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

AIMS: Coronary artery occlusion is associated with the risk of ventricular remodelling, heart failure, and cardiogenic shock. Novel strategies are sought to treat these ominous complications. We examined the effect of a pericardial-derived fat flap secured over an acute infarct caused by coronary occlusion.

METHODS AND RESULTS: A novel intervention consisting of the pericardial isolation of a vascularized adipose flap and its transposition fully covering acute infarcted myocardium was developed in the swine model of coronary artery ligation (n= 52). Left ventricular (LV) ejection fraction and LV end-diastolic and end-systolic volumes were assessed using magnetic resonance imaging (MRI). Infarct size and gene expression analysis were performed on Day 6 and 1 month. Histological changes, collagen volume fraction (CVF), and vascular density were also evaluated on postmortem sections. One month after the intervention, a 18.8% increase in LV ejection fraction (P= 0.007), and significant reductions in LV end-systolic (P= 0.009) and LV end-diastolic volumes (P= 0.03) were found in treated animals compared with the control-MI group. At Day 6, histopathology confirmed a significant infarct size reduction (P= 0.018), the presence of vascular connections at the flap-myocardium interface, and less apoptosis in the infarct border zone compared with control animals (P< 0.001). Up-regulation of genes involved in cell cycle progression, cellular growth and proliferation, and angiogenesis were identified within the flap.

CONCLUSIONS: Our results indicate that a vascular fat flap exerts beneficial effects on LV function and limits myocardial remodelling. Future studies must confirm whether these findings provide an alternative therapeutic approach for myocardial salvage after infarction.

Original languageEnglish
Pages (from-to)659-67
Number of pages9
JournalCardiovascular Research
Volume91
Issue number4
DOIs
Publication statusPublished - 1 Sep 2011

Cite this

Gálvez-Montón, C., Prat-Vidal, C., Roura, S., Farré, J., Soler-Botija, C., Llucià-Valldeperas, A., ... Bayes-Genis, A. (2011). Transposition of a pericardial-derived vascular adipose flap for myocardial salvage after infarct. Cardiovascular Research, 91(4), 659-67. https://doi.org/10.1093/cvr/cvr136