Percutaneous pericardiotomy sustained acute hemodynamic benefits for at least 4 weeks in a swine model of heart failure with preserved ejection fraction, without excessive chamber remodeling.
Does minimally invasive percutaneous pericardiotomy provide sustained improvement in hemodynamics in a porcine model of heart failure with preserved ejection fraction?
Percutaneous pericardiotomy provides sustained improvement in diastolic reserve without adverse remodeling in a porcine model of HFpEF, supporting future human trials.
p-value: p==0.28
BACKGROUND: Heart failure with preserved ejection fraction is increasing in prevalence, but few effective treatments are available. Elevated left ventricular (LV) diastolic filling pressures represent a key therapeutic target. Pericardial restraint contributes to elevated LV end-diastolic pressure, and acute studies have shown that pericardiotomy attenuates the rise in LV end-diastolic pressure with volume loading. However, whether these acute effects are sustained chronically remains unknown. METHODS: Minimally invasive pericardiotomy was performed percutaneously using a novel device in a porcine model of heart failure with preserved ejection fraction. Hemodynamics were assessed at baseline and following volume loading with pericardium intact, acutely following pericardiotomy, and then again chronically after 4 weeks. Cardiac structure was assessed by magnetic resonance imaging. RESULTS: =0.28 versus acute). There was no statistically significant effect of pericardiotomy on ventricular remodeling compared with age-matched controls. None of the animals developed hemodynamic or pathological indicators of pericardial constriction or frank systolic dysfunction. CONCLUSIONS: The acute hemodynamic benefits of pericardiotomy are sustained for at least 4 weeks in a swine model of heart failure with preserved ejection fraction, without excessive chamber remodeling, pericarditis, or clinically significant systolic dysfunction. These data support trials evaluating minimally invasive pericardiotomy as a novel treatment for heart failure with preserved ejection fraction in humans.
Jain et al. (Fri,) conducted a other in Heart failure with preserved ejection fraction. Minimally invasive percutaneous pericardiotomy vs. Baseline (pericardium intact) and age-matched controls was evaluated on Hemodynamics following volume loading and cardiac structure (p==0.28). Percutaneous pericardiotomy sustained acute hemodynamic benefits for at least 4 weeks in a swine model of heart failure with preserved ejection fraction, without excessive chamber remodeling.
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