Az emberi szívizominfarktus jól reprodukálható sertésmodellje

Andréka, György and Andréka, Lilla and Font, Gusztáv and Vértesaljai, Márton and Fontos, Géza and Garamvölgyi, Rita and Hevesi, Ákos and Petrási, Zsolt and Egri, Borisz and Szabó, Ferenc and Andréka, Péter (2024) Az emberi szívizominfarktus jól reprodukálható sertésmodellje. MAGYAR ÁLLATORVOSOK LAPJA, 146 (8). pp. 465-474. ISSN 0025-004X

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Abstract

A sertéseket gyakran alkalmazzák az intervenciós kardiológiai kutatásokban a humán kardiológiához való hasonlóságuk, valamint a humán koronária katéterrendszerek és technikák sertésekben való könnyű használhatósága miatt. Munkánkban az emberi ST-elevációs szívizominfarktus sertésmodelljét vizsgáltuk, amit ST-szakasz emelkedéssel, a teljes szérum kreatinin-kináz felszabadulással, gadolinium kontraszt MRI-vel és szövettannal igazoltunk. Bizonyítottuk, hogy a modell kivitelezhető, reprodukálható, költséghatékony és a létrehozott szívinfarktus hasonló az emberi szívinfarktushoz. Munkánkból kitűnik, hogy csak az állatorvosok és a humán kardiológusok együttműködésével lehet a sertés koronária vizsgálatok nehézségeit kiküszöbölni, és ezek a komplex beavatkozások csak így vihetők sikerre. | Background: Coronary artery disease is the leading cause of death in the developed countries and myocardial infarction is the most serious manifestation of the disease. Swine are being chosen with increasing frequency as subject for interventional cardiology research. Their similarities to humans in their cardiovascular physiology, size and coronary anatomy make them better experimental subjects than most species. Moreover, regular human coronary catheter systems and techniques can be readily used to access their coronary vasculature. Objectives: In this paper, a simple swine model of human myocardial infarction is studied in detail using a percutaneously inserted balloon catheter. The main role of the present paper is to introduce and troubleshoot the technique and its potential pitfalls. Materials and Methods: Myocardial infarction was confirmed by the detection of ST segment elevation on the surface ECG, total creatine kinase release, gadolinium enhanced contrast MRI scan and by histology. Results and Discussion: We conclude that if investigators are familiar with both human and animal research, this model is practical, inexpensive and can provide reproducible and consistent infarct sizes that closely mimic the human myocardial infarction. With very careful technique inducing LAD infarction distal to the second diagonal branch and done by trained team, our mortality was lower than in the literature, only 12.5%. It was also proven that the size of myocardial infarction induced by this technique was big enough to be used for different interventional cardiology research. From our study, it is clearly visible, that only a close collaboration between veterinary medicine and human cardiology can avoid the difficulties of complex swine coronary experiments and leads to success.

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