July 22, 2019Open Access

Cardiac contractility modulation regulates the structural and electrical remolding in chronic heart failure rabbit model

Q: What is the clinical evidence from this study?

Population: Chronic heart failure (n=30). Intervention: Cardiac contractility modulation vs. Untreated heart failure group. Primary outcome: Myocardial hydroxyproline content (μg/mg) (p=<0.01).

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Key result

Cardiac contractility modulation significantly reduced myocardial hydroxyproline content (0.69 vs 0.98 μg/mg) and shortened QTc intervals in a rabbit model of chronic heart failure.

Why the study?

Chronic heart failure involves structural and electrical remodeling, and this study evaluated the effects of cardiac contractility modulation on these remodeling processes in a rabbit model.

Does cardiac contractility modulation prevent structural and electrical remodeling in a rabbit model of chronic heart failure?

Structured PICO

Does cardiac contractility modulation prevent structural and electrical remodeling in a rabbit model of chronic heart failure?

Population

30 New Zealand white rabbits with chronic heart failure induced by trans aortic constriction, treated with cardiac contractility modulation for 4 weeks.

Intervention

Cardiac contractility modulation (CCM) delivered via epicardial pacing lead (biphasic square-wave pulses, 2 ms duration, 7 V amplitude, 30 ms delay after R-wave) for 6 hours per day for 4 weeks.

Comparator

Heart failure model without CCM therapy (and sham-operated controls).

Outcome

Structural changes (myocardial fibrosis, hydroxyproline content) and electrical remodeling (QTc interval, effective refractory period, VT inducibility, and protein expression of CTGF, Gal-3, Kv4.3, KCNQ1, KCNH2, CX43).surrogate

Main Result

Absolute Event Rate: 0.69% vs 0.98%

p-value: p=<0.01

In a rabbit model of chronic heart failure, cardiac contractility modulation prevented structural and electrical remodeling, providing experimental support for its anti-arrhythmic and anti-fibrotic benefits.

Limitations

Sample size was relatively small
Unclear whether heart failure from another model as volume overload or tachycardia leads to similar results
Did not perform patch clamp studies to explore the effect of CCM on ion channel's function
Small sample size
Unclear if results apply to other heart failure models (e.g., volume overload or tachycardia)
Lack of patch clamp studies to explore the effect of CCM on ion channel function

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Hypothesis-generating for CCM in experimental HF remodeling; leaves open translation to clinical practice.

Cite This Study

Zhang et al. (2019) studied Chronic heart failure (n=30). Cardiac contractility modulation vs. Untreated heart failure group was evaluated on Myocardial hydroxyproline content (μg/mg) (p=<0.01). Cardiac contractility modulation significantly reduced myocardial hydroxyproline content (0.69 vs 0.98 μg/mg) and shortened QTc intervals in a rabbit model of chronic heart failure.

synapsesocial.com/papers/6a9c8442771247d313069dcb https://doi.org/10.21203/rs.2.11761/v1

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Cardiac contractility modulation regulates the structural and electrical remolding in chronic heart failure rabbit model

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Cardiac contractility modulation regulates the structural and electrical remolding in chronic heart failure rabbit model

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider