Epicardial infarct repair with basic fibroblast growth factor–enhanced CorMatrix-ECM biomaterial attenuates postischemic cardiac remodeling  Holly E.M.

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Epicardial infarct repair with basic fibroblast growth factor–enhanced CorMatrix-ECM biomaterial attenuates postischemic cardiac remodeling  Holly E.M. Mewhort, MD, Jeannine D. Turnbull, BSc, H. Christopher Meijndert, MBT, Janet M.C. Ngu, MD, MSc, Paul W.M. Fedak, MD, PhD, FRCSC  The Journal of Thoracic and Cardiovascular Surgery  Volume 147, Issue 5, Pages 1650-1659 (May 2014) DOI: 10.1016/j.jtcvs.2013.08.005 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Left ventricles (LVs) transected longitudinally through the anterior and posterior walls to reveal the infarcted myocardium within the anterior wall (indicated by the arrowheads). B, Passive pressure distension was performed in explanted LVs from normal, sham, nonenhanced CorMatrix-ECM patch (CorMatrix Cardiovascular Inc, Roswell, Ga), and basic fibroblast growth factor (bFGF)–enhanced CorMatrix-ECM patch animals (n = 5 per group). The LV volume at 30 mm Hg was recorded and compared between groups as an index of chamber size. C, Passive pressure-volume curves from normal, nonenhanced, and sham animals are shown and confirm that chamber compliance was similar between groups. ∗P < .05. ECM, Extracellular matrix. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1650-1659DOI: (10.1016/j.jtcvs.2013.08.005) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Myocardial tissue from a nonenhanced CorMatrix-ECM patch (CorMatrix Cardiovascular Inc, Roswell, Ga) animal. A, Histology. B, Immunohistochemistry. Arrowheads outline the myocardium-patch interface, green color indicates troponin, orange color indicates collagen, and blue indicates nucleus. ∗CorMatrix-ECM patch material. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1650-1659DOI: (10.1016/j.jtcvs.2013.08.005) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Immunohistochemistry. A, Normal myocardium. B, Infarcted myocardium from a sham. C, Nonenhanced CorMatrix-ECM patch (CorMatrix Cardiovascular Inc, Roswell, Ga). D, Basic fibroblast growth factor (bFGF)–enhanced CorMatrix-ECM patch animal stained with anti-collagen (orange) and 4′6-diamino2-phenylindol (blue). E, In vivo CorMatrix-ECM patch stained with anti-collagen (orange). F, In vivo CorMatrix-ECM patch stained with anti-alpha-smooth muscle actin (green) and 4′6-diamino2-phenylindol (blue). SIS ECM, Small intestine submucosa extracellular matrix. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1650-1659DOI: (10.1016/j.jtcvs.2013.08.005) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 CorMatrix-ECM patch (CorMatrix Cardiovascular Inc, Roswell, Ga) animal stained with anti-basic fibroblast growth factor (bFGF) (red) and 4′6-diamino2-phenylindol (blue). A, In vivo nonenhanced. B, bFGF-enhanced. C, CorMatrix-ECM and infarcted myocardium from a sham. D, Nonenhanced. E, bFGF-enhanced. F, Western blot for bFGF performed on the bFGF-enhanced CorMatrix-ECM patch before implantation. SIS ECM, Small intestine submucosa extracellular matrix. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1650-1659DOI: (10.1016/j.jtcvs.2013.08.005) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Hemodynamic parameters. A, Ejection fraction measured 16 weeks post-treatment by echocardiography in normal (n = 13), sham (n = 15), nonenhanced CorMatrix-ECM patch (CorMatrix Cardiovascular Inc, Roswell, Ga) (n = 18), and basic fibroblast growth factor (bFGF)–enhanced CorMatrix-ECM patch (n = 10) animals. B, Pressure-volume (PV) loop analysis in normal (n = 8), sham (n = 6), nonenhanced CorMatrix-ECM patch (n = 7), and bFGF-enhanced CorMatrix-ECM patch (n = 5) animals. C, Changes in ejection fraction measured by echocardiography over the time course of the experiment in normal (n = 13), sham (n = 15), and CorMatrix-ECM patch (n = 28; patch group includes non-enhanced and bFGF-enhanced CorMatrix-ECM patch) animals. D, Left ventricular end diastolic volume (LVEDV) measured by PV loop 16 weeks post-treatment. E, Contractility was reflected by the end systolic pressure volume relationship (ESPVR) measured by PV loop 16 weeks post-treatment. F, Ventricular compliance was reflected by the end diastolic pressure volume relationship (EDPVR) measured by PV loop 16 weeks post-treatment. ∗P < .05. ∗∗P < .01. ∗∗∗P < .001. ∗∗∗∗P < .0001. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1650-1659DOI: (10.1016/j.jtcvs.2013.08.005) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions