Abstract
Objective. Pathomechanism of coronary slow flow phenomenon remains largely unclear now. Present study observed the pathological and angiographic evolution in a pig model of coronary slow flow. Methods. Coronary slow flow was induced by repeat coronary injection of small doses of 40 µm microspheres in 18 male domestic pigs and angiographic and pathological changes were determined at 3 hours, 7 days, and 28 days after microspheres injection. Results. Compared to control group treated with coronary saline injection (n = 6) and baseline level, coronary flow was significantly reduced at 3 hours and 7 days but completely recovered at 28 days after coronary microsphere injection in slow flow group. Despite normal coronary flow at 28 days after microsphere injection, enhanced myocardial cytokine expression, left ventricular dysfunction, adverse remodelling, and ischemia/microembolism related pathological changes still persisted or even progressed from 3 hours to 28 days after coronary microsphere injection. Conclusions. Our results show that this large animal slow flow model could partly reflect the chronic angiographic, hemodynamic, and pathological changes of coronary slow flow and could be used to test new therapy strategies against the slow flow phenomenon.
Highlights
Coronary slow flow phenomenon (CSFP) is a disease entity referring to the angiographic observation of delayed contrast filling of the coronary vasculature in the absence of an anatomic obstruction during coronary angiography [1]
CSFP is related to poor outcome in patients treated with percutaneous transluminal coronary angioplasty (PCI) for first acute myocardial infarction (AMI) compared with PCI treated AMI patients without CSFP and in patients solely diagnosed with CSFP compared with patients without CSFP [5, 6]
Left ventricular (LV) apex was cut for Western blot analysis and LV free wall near LV apex was cut into 0.5 cm × 0.5 cm block and fixed in 10% formalin for three days and it was dehydrated, paraffin-embedded, and cut into 4 μm sections for hematoxylin and eosin (HE), hematoxylinbasic fuchsin-picric acid (HBFP), and Carstairs staining
Summary
Present study observed the pathological and angiographic evolution in a pig model of coronary slow flow. Coronary slow flow was induced by repeat coronary injection of small doses of 40 μm microspheres in 18 male domestic pigs and angiographic and pathological changes were determined at 3 hours, 7 days, and 28 days after microspheres injection. Despite normal coronary flow at 28 days after microsphere injection, enhanced myocardial cytokine expression, left ventricular dysfunction, adverse remodelling, and ischemia/microembolism related pathological changes still persisted or even progressed from 3 hours to 28 days after coronary microsphere injection. Our results show that this large animal slow flow model could partly reflect the chronic angiographic, hemodynamic, and pathological changes of coronary slow flow and could be used to test new therapy strategies against the slow flow phenomenon
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