Bilateral sympathectomy improves postinfarction left ventricular remodeling and function Fernando Luiz Zanoni, DVM, PhD, Rafael Simas, PhD, Raphael Grillo.

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Presentation transcript:

Bilateral sympathectomy improves postinfarction left ventricular remodeling and function Fernando Luiz Zanoni, DVM, PhD, Rafael Simas, PhD, Raphael Grillo da Silva, DVM, Ana Cristina Breithaupt-Faloppa, PhD, Raphael dos Santos Coutinho e Silva, BSc, Fábio Biscegli Jatene, MD, PhD, Luiz Felipe P. Moreira, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 153, Issue 4, Pages 855-863.e1 (April 2017) DOI: 10.1016/j.jtcvs.2016.11.037 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Representative photomicrographs of the left ventricular myocardium stained with Masson's trichrome in gross section (A) or with 20× augmentation (B), showing the intensity of fibrotic tissue in the 3 groups. *Represents the lumen of the left ventricle. MI, Myocardial infarction; LS, left sympathectomy; BS, bilateral sympathectomy. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 855-863.e1DOI: (10.1016/j.jtcvs.2016.11.037) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Myocardial efficiency estimated by P-V loop analysis at steady-state and under DBT infusion at 2.5 and 5.0 μg/kg/min. Data are presented as mean ± standard deviation for 7 animals in each group. DBT, Dobutamine; MI, myocardial infarction; LS, left sympathectomy; BS, bilateral sympathectomy. *P < .005 versus sham; **P < .05 versus sham; ##P < .05 versus MI. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 855-863.e1DOI: (10.1016/j.jtcvs.2016.11.037) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Gene expression of MMP-2 and -9 in left ventricular myocardium. Data are presented as mean ± standard deviation for 7 animals in each group. *P < .05 versus MI; #P < .001 versus MI. MMP-2, Metalloproteinase-2; MI, myocardial infarction; LS, left sympathectomy; BS, bilateral sympathectomy. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 855-863.e1DOI: (10.1016/j.jtcvs.2016.11.037) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Gene expression and protein content of VEGF in the left ventricular myocardium. Data are presented as mean ± standard deviation for 7 animals in each group. *P < .01 versus sham; #P < .05 versus MI. VEGF, Vascular endothelial growth factor; MI, myocardial infarction; LS, left sympathectomy; BS, bilateral sympathectomy. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 855-863.e1DOI: (10.1016/j.jtcvs.2016.11.037) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Bcl-2 and caspase-3 expression in the left ventricular myocardium. Data are presented as mean ± standard deviation for 7 animals in each group. *P < .01 versus sham; #P < .05 versus MI. MI, Myocardial infarction; LS, left sympathectomy; BS, bilateral sympathectomy. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 855-863.e1DOI: (10.1016/j.jtcvs.2016.11.037) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Left ventricle fibrosis is reduced by bilateral sympathectomy. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 855-863.e1DOI: (10.1016/j.jtcvs.2016.11.037) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Video 1 A short demonstration of the rat model of myocardial infarction and stellate ganglion chemical sympathectomy. Video available at: http://www.jtcvsonline.org/article/S0022-5223(16)31632-4/addons. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 855-863.e1DOI: (10.1016/j.jtcvs.2016.11.037) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions