Key result
Coronary sinus ligation in dogs with myocardial infarction significantly decreased left ventricular fractional shortening (P=0.0001) and ejection fraction (P=0.002) compared to MI controls.
Why the study?
Does coronary sinus ligation affect myocardial structure and function in normal hearts and hearts with structural disease?
Does coronary sinus ligation affect myocardial structure and function in normal hearts and hearts with structural disease?
Acute coronary sinus occlusion can be compensated in normal hearts but causes significant left ventricular dysfunction and myocardial degeneration in the presence of prior myocardial infarction.
Raises caution for coronary sinus interventions post-MI; leaves open translational safety in human structural heart disease.
AIMS: To study the effect of coronary sinus (CS) occlusion on normal hearts and hearts with structural disease. METHODS AND RESULTS: We included 32 dogs, divided into 4 groups: (1) CS ligation (CSL): subjected to CSL; (2) control group: no intervention; (3) MI-CSL group: subjected to myocardial infarction (MI) induction followed by CSL after 1 week; and (4) MI-control group: subjected to MI induction, then open thoracotomy after 1 week without CSL. Electrocardiography, echocardiography, histopathology, and immunohistochemistry were done before and after CSL. In CSL group, there were no significant electrocardiographic or echocardiographic changes after CSL, although there was interstitial oedema that decreased after 1 week with the appearance of Thebesian vessels and positive staining for vascular endothelial growth factor. In MI-CSL group, there was significant increase in left ventricular (LV) end-systolic diameter (P = 02), decrease in LV fractional shortening (P = 0.0001), and LV ejection fraction (P = 0.002) in comparison with MI-control group, associated with severe myocardial degeneration. CONCLUSION: Acute CS occlusion could be compensated in normal hearts, but may be detrimental in the presence of structural heart disease.
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Diab et al. (2016) studied Myocardial infarction (n=32). Coronary sinus ligation vs. No intervention or open thoracotomy without ligation was evaluated on Left ventricular fractional shortening (p=0.0001). Coronary sinus ligation in dogs with myocardial infarction significantly decreased left ventricular fractional shortening (P=0.0001) and ejection fraction (P=0.002) compared to MI controls.
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