We thank Fred Roberts for exemplary technical support and also appreciate the help from the histology core in Beth Israel Hospital. We thank Brigham Women&#8217;s Hospital Cardiovascular Physiology Core for providing with the instrumentation and the funds for this work. This work was supported in part by a Department of Medicine Sundry Fund.

注：すべての手順は、米国獣医師会（AVMA）のガイドラインに従ってマウスで行われ、施設内動物管理使用委員会（IACUC）のプロトコルを承認された。 1.研究デザイン<ol><li>研究では8〜10週齢の雄のC57BL / 6マウス（BW〜25グラム）を使用します。 </li><li>マウスをランダムた（n = 11）の2つのグループに、大動脈バンディングのために選択試験群（n = 8）および対照群（n = 3）を介して、開胸偽手術を受ける。 </li><li>医療グレードで脱毛クリームを使用して、胸から毛を除去することにより、画像化のために動物を準備します。 </li><li> （ノーズコーンを介して100％のO 2と混合）1％および2.5％のイソフルラン麻酔誘発性の範囲の間、-1日目にベースラインのパラメータを決定するために、大動脈結紮の24時間前に第1の超音波（第2）を行う。 </li><li>医学的に承認された麻酔薬を選択してください（ つまり、イソフルラン）と寄り付きに麻酔（2から3パーセントの程度を監視するCE、および維持するための1.0％）。 注：適切な麻酔は通常の生理学的速度（約500拍/分）でのハートビートの維持に重要である。 </li><li>ペダル引っ込め反射に応答した動物からの動きの損失によって麻酔の深さを確認してください。麻酔下ながら乾燥を防ぐために、目にparalube獣医軟膏を使用してください。 </li><li> 0日目20,21で手術を行う。 </li><li>大動脈バンディングについては、アーチ上に置かれ、テーパ26 G針を中心に7-0絹縫合糸を使用して大動脈を結紮。 注：外科大動脈バンディング手順を含む実験プロトコルに関する詳細は、以前に20,21に記載されている。 </li><li>術後超音波イメージング（セクション2）日で（複数の）2,6及び13を実行する。 </li><li> 14日目にマウスを安楽死させると組織学的評価のために心を収穫。心臓などの重要臓器を除去したペントバルビタールの過剰摂取を使用して、動物を安楽死させる。 diastoに心を逮捕LEとホルマリンで固定します。以前に22に記載されている心臓の収穫の手順を使用します。 </li><li>バッファリングされた10％ホルマリン溶液でのすべての心臓組織を修正。トリクローム染色のために、切片の前にパラフィン中に組織を埋め込む。よく以前に14,23説明してきたトリクローム染色の詳細を使用してください。 </li><li>オフラインソフトウェア（セクション3）を使用してデータを分析します。 </li></ol> 2.イメージングプロトコル<ol><li>中隔冠動脈のロングとショート軸像（SCA）（B-モード） <ol><li>アクティブポートに接続された40 MHzの中​​心周波数でMS550Dプローブを用いて、「心臓イメージング」への適用プリセットを設定する。 </li><li>加熱されたプラットフォーム上で、ノーズコーンを介して制御麻酔下の動物の仰臥位では、胸骨傍長軸ビュー（PSLAX）（ 図1A）を得るためにレールシステムを使用してプローブを配置する。常に動物が予め温めplatforに保温されていることを確認m及び体温を生理学的レベルに維持される。 </li><li> （ノッチが尾側に向くように）プローブ角度が左胸骨傍のライン（長軸ビュー）（ 図1B）に15°であるように時計回りにプローブを回転させます。 </li><li>画面（ 図1B）の中央にSCAの全長の縦断面を得るために、プローブのy軸に沿ってわずかに傾斜させることによって、プローブの角度を調節する。 </li><li>適切な目印（大動脈弁及び肺動脈）は、シネ·ストアの可能な限り最高のフレームレートを使用して画像を見たら。 </li><li> 「のxy &quot;を使用して、SCAの鮮明な画像を得るためのプローブ位置を調整し、マイクロマニピュレーター（ 図1D）を軸。 </li><li> （ノッチが尾側に向くように）プローブをプローブの切り欠き端が正中線の左側（短軸）（ 図1C）にあるように、時計回りに90°回転します。 </li></ol></li><li> SCAのロングとショート軸像（カラー·ドップラーのModE） <ol><li> Bモード画像を撮影またはシネ格納されると、カラードップラー音響窓（ 図2）をオンにするキーボードのカラードプラキーをクリックする。 注：これは、長い（ 図2A）または短軸（ 図2C）のいずれかで（白い矢印がSCAを示す）冠動脈を特定するのに役立ちます。赤色がリアルタイムに見られるようにし、（離れて大動脈弁の）流れの方向を示している。 </li><li> （画像画面の右側に黄色い矢印で示す）は、焦点深度は、冠動脈の中心にあることを確認してください。 </li><li>データは可能な限り高いフレームレート（&gt; 100フレーム/秒）で、シネストアキーを使用して、記録されていることを確認してください。 </li></ol></li><li> SCAのPWドップラーイメージング（パルス波またはPWモード） <ol><li>カラードプラモードにある間、冠状動脈（赤で示した図2、）に黄色のインジケータラインを表示するためにPW]キーをクリックしてください。 </li><li>黄色を配置流れの方向と平行する方向のビ​​ュー内の冠状動脈の中央にPWライン。速度測定は、画像取得の角度に大きく依存することに注意してください。 </li><li> PW角度キーが60°以下であり、サンプルの体積はSCAの中心に流れ権利を捕捉するように流れの角度（PW角度キー）及びサンプルボリューム（SVキー）を調整する。 </li><li> 1％および2.5％イソフルランを使用して、ピーク収縮期（S）および拡張期（D）（ 図3Aおよび図3B）における冠血流速度を示す波形を捕捉するためにシネ·ストアを使用する。 </li></ol></li></ol> 3.データの計算と分析<ol><li> 図3Aおよび3Bに示されている画像からのピーク収縮期および拡張期速度を得るために、速度の時間積分（VTI）ツールを選択します。 </li><li>充血の割合（2.5％イソフルラン）ピーク拡張期fとして冠血流予備インデックス（CFR）を計算ベースライン（1％イソフルラン）最大拡張期流速を低速。 </li><li>ピーク収縮期冠動脈流速/ピーク拡張期冠血流速度としてS / D比を計算します。ベースラインでの割合（1％イソフルラン）と充血で（2.5％イソフルラン）を決定します。 </li><li>そのようなFS、FAC、LVMなどの標準的な心機能のパラメータについては、独自のソフトウェアを使用してデータ分析を実行したり、チェンのJoveの紙2を参照するために、メーカーからの説明書を参照してください。 </li></ol>

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The authors report no disclosures.

この超音波ベースの研究では、冠血流の非侵襲的評価は、再現性のライブ実験マウスにおいて、日にわたって、リアルタイムで行われた。さらに、プロトコルは、初期の段階で存在し、心筋灌流における欠乏に関連した冠状動脈機能不全を検出するための可能性を実証した。この方法は、最終的に心血管リスク層別化および/または治療的介入に対する応答を評価するための臨床ツールとして...

臨床大動脈弁狭窄（AS）がよく、左心室（LV）の後負荷の漸進的増加を促進することが知られている。この慢性的に上昇する血行動態の負荷を補償するために、左室肥大（LVH）は、適応応答1,2としてすさまじい。 LVHの開発は、多くの場合、冠微小循環の異常と関連している。これは、微小血管の機能障害は、これらの患者5の慢性虚血に寄与すると考えられている。冠血流3,4に加えて、冠血流予備能（CFR）は、冠状動脈1,3の機能変化を表しており、ベースライン流速または休止流速4,6,7に充血の最大流速の比として定義される。 CFRは、LVリモデリング1-3,5-9の間に減少し、冠状動脈不全1,10,17の機能的重症度の程度の指標として用いられる。これは、拡張型心筋症10と冠状sの多くの形態が損なわれることが知られているtenosis 6。 CFRも不良な臨床転帰12の予後マーカーである。 そのような虚血またはLVHなどの心機能障害の設定でLVリモデリングにも豊富な線維症、冠状動脈1,2の冠動脈微小循環と肥厚の変化を伴っている。冠状生理におけるこれらの変化の結果として、冠状動脈の可能性リモデリングがある。これは、低酸素拡散と心筋虚血の1,2,13に対する感受性の原因となり、LV拡張機能障害の影響を軽減するのに役立ちます。 遺伝的に変更されたマウスは、そのような冠状動脈アテローム性動脈硬化症5,7,10,12,17ようになりましたヒトの疾患状態を模倣するために広く普及して治験ツールです。特にマウスにおける圧負荷モデルが広く14,17に研究されている。トランス大動脈狭窄モデル（TAC）は、広範な線維症と関連することが示され、coronarされているyの狭窄冠動脈の内側肥厚およびヒトにおけるLVHの設定で見られるものと同様の冠血流パターン1,11,17,19の変化を伴うと、部分的には、結果として生じる。それは長期の圧負荷は約4~8週間で非代償性心不全につながることが知られているが、バンディング後のこれらのモデルにおいて、初期の疾患の進行の過程において、および異なる段階で冠血流動態および血流予備への影響は、まだある明瞭に描写される。 マウスの多くの株は十分に特徴付けられたLDLRを含む、研究用途のために現在利用可能である- / -またはアポE - / -マウス10-12、これらは生きているマウス11-15心臓血管機能および形態を評価するための敏感な技術の開発を促した。このような技術は、MRI、PET、CTコントラスト、高周波数超音波、および浸潤に有望な代替物を提供するこれらの全ての電子ビーム断層撮影法2,9,17,19を含む心臓カテーテル法と冠動脈造影12のような方法。しかしながら、冠状動脈の非常に小さいサイズ、高い心拍数（HR）を有するマウスにおいて、冠循環のイメージングは、依然として多くの現在利用可能な技術4,12のための技術的な課題である。興味深いことに、15から約30-100ミクロンの軸方向の解像度を可能にする50MHzの中​​心周波数の高周波アレイ·スキャンヘッドの開発など、経胸​​壁ドップラー心エコー検査（TTDE）の分野における技術の進歩、指数関数的上昇があった、 400フレーム捕捉/秒より大きい8〜40ミリメートル、及びフレームレートの深さで。ターンでは、TTDEベースの技術は、2より大きい、またはそのような冠状動脈5,12としてさらに小さな血管を画像化するための潜在的に強力なツールとして浮上している。 研究者は小さなAの血管系の画像診断試験を実施することができましたもう一つの重要な前進nimals 11を撮像中の心拍や動物の呼吸速度を維持麻酔薬の慎重に制御を使用することである。制御された麻酔の維持は、マウスにおいて血管拡張に関連する研究のために特に重要であり、麻酔の効果はまた、このコンテキスト10,11で検討する必要がある。ヒトでは、一方で、TTDE由来のCFRの測定は、主に左前下行（LAD）冠動脈5,16において、狭窄および非閉塞し心外膜冠動脈の評価のためのより一般的に使用されるツールとなっている。しかし、安静時の保存LV収縮機能とCFRと無症候性患者やマウスでの冠血流変化の予後の役割は、はるかに少ない16を検討されている。したがって、研究の目的は、第一の圧負荷マウスモデルにおいてTTDEを用いた冠状動脈流の変化を評価するために、明確なステップバイステップのプロトコルを確立することであった。第二に、この研究では、予後のサインを検討CFRおよびこれらのマウスにおける圧負荷ストレスに応答して冠血流の変化ificance。私たちは、CFRと冠血流のTTDEベースの評価は左室機能障害に先行してもよい冠動脈機能障害の早期発見に有用である可能性があるという仮説を立てた。

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ultrasound based assessment of coronary artery flow and coronary flow reserve using the pressure overload model in mice

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow reserve (CFR) in humans. Reduced CFR is accompanied by marked intramyocardial and pericoronary fibrosis and is used as an indication of the severity of dysfunction. This study explores, step-by-step, the real-time changes measured in the coronary flow velocity, CFR and systolic to diastolic peak velocity (S/D) ratio in the setting of an aortic banding model in mice. By using a Doppler transthoracic imaging technique that yields reproducible and reliable data, the method assesses changes in flow in the septal coronary artery (SCA), for a period of over two weeks in mice, that previously either underwent aortic banding or thoracotomy. 
During imaging, hyperemia in all mice was induced by isoflurane, an anesthetic that increased coronary flow velocity when compared with resting flow. All images were acquired by a single imager. Two ratios, (1) CFR, the ratio between hyperemic and baseline flow velocities, and (2) systolic (S) to diastolic (D) flow were determined, using a proprietary software and by two independent observers. Importantly, the observed changes in coronary flow preceded LV dysfunction as evidenced by normal LV mass and fractional shortening (FS). 
The method was benchmarked against the current gold standard of coronary assessment, histopathology. The latter technique showed clear pathologic changes in the coronary artery in the form of peri-coronary fibrosis that correlated to the flow changes as assessed by echocardiography. 
The study underscores the value of using a non-invasive technique to monitor coronary circulation in mouse hearts. The method minimizes redundant use of research animals and demonstrates that advanced ultrasound-based indices, such as CFR and S/D ratios, can serve as viable diagnostic tools in a variety of investigational protocols including drug studies and the study of genetically modified strains.

研究された11匹のマウス（バンドはn = 8、偽手術、n = 3）を、適切かつ再現可能な画像は、いくつかの時点で、単一の観察者により得られた：ベースライン（D-1）において、D2、D6及びD13 。また、狭窄部位での流速は、手術の翌日に（p &lt;0.05）に偽手術マウスにおいて277.5±10.51ミリメートル/秒と比較して、110.9ミリメートル/秒±2225として測定した。速度の増加は、圧負荷モデルの確立に成功の...

Watch this Scientific Journal Video about Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice at JoVE.com

Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

Coronary flow reserve (CFR) is useful for assessment of myocardial oxygen demand and evaluation of cardiovascular risk. This study establishes a step-by-step transthoracic Doppler echocardiographic (TTDE) method for longitudinal monitoring of the changes in CFR, as measured from coronary artery in mice, under the experimental pressure overload of aortic banding.

マウスの圧負荷モデルを用いた冠動脈の流れと冠血流準備の超音波ベースのアセスメント

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow ...

ultrasound-based-assessment-coronary-artery-flow-coronary-flow

Research

JoVE Journal

Medicine

14.8K ビュー.  Brigham and Women's Hospital, Harvard Medical School. Coronary flow reserve (CFR) is useful for assessment of myocardial oxygen demand and evaluation of cardiovascular risk. This study establishes a step-by-step transthoracic Doppler echocardiographic (TTDE) method for longitudinal monitoring of the changes in CFR, as measured from coronary artery in mice, under the experimental pressure overload of aortic banding.

ビデオ: Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

Use of a Hanging Weight System for Coronary Artery Occlusion in Mice

Murine studies of acute injury are an area of intense investigation, as knockout mice for different genes are becoming increasingly available 1-38. Cardioprotection by ischemic preconditioning (IP) remains an area of intense investigation. To further elucidate its molecular basis, the use of knockout mouse studies is particularly important 7, 14, 30, 39. Despite the fact that previous studies have already successfully performed cardiac ischemia and reperfusion in mice, this model is technically very challenging. Particularly, visual identification of the coronary artery, placement of the suture around the vessel and coronary occlusion by tying off the vessel with a supported knot is technically difficult. In addition, re-opening the knot for intermittent reperfusion of the coronary artery during IP without causing surgical trauma adds additional challenge. Moreover, if the knot is not tied down strong enough, inadvertent reperfusion due to imperfect occlusion of the coronary may affect the results. In fact, this can easily occur due to the movement of the beating heart.
Based on potential problems associated with using a knotted coronary occlusion system, we adopted a previously published model of chronic cardiomyopathy based on a hanging weight system for intermittent coronary artery occlusion during IP 39. In fact, coronary artery occlusion can thus be achieved without having to occlude the coronary by a knot. Moreover, reperfusion of the vessel can be easily achieved by supporting the hanging weights which are in a remote localization from cardiac tissues.
We tested this system systematically, including variation of ischemia and reperfusion times, preconditioning regiments, body temperature and genetic backgrounds39. In addition to infarct staining, we tested cardiac troponin I (cTnI)
as a marker of myocardial infarction in this model. In fact, plasma levels of cTnI correlated with infarct sizes (R2=0.8). Finally, we could show in several studies that this technique yields highly reproducible infarct sizes during murine IP and myocardial infarction6, 8, 30, 40, 41. Therefore, this technique may be helpful for researchers who pursue molecular mechanisms involved in cardioprotection by IP using a genetic approach in mice with targeted gene deletion. Further studies on cardiac IP using transgenic mice may consider this technique.

A murine model for myocardial ischemia and ischemic preconditioning is an important tool study cardioprotective mechanisms in vivo. Here, we report an easy applicable in situ model for cardiac IP using a hanging-weight system for coronary artery occlusion.

マウスにおける冠動脈閉塞のために掛かる重量のシステムの使用

Murine studies of acute injury are an area of intense investigation, as knockout mice for different genes are becoming increasingly available 1-38. ...

医学

Coronary Artery Ligation and Intramyocardial Injection in a Murine Model of Infarction

Mouse models are a valuable tool for studying acute injury and chronic remodeling of the myocardium in vivo. With the advent of genetic modifications to the whole organism or the myocardium and an array of biological and/or synthetic materials, there is great potential for any combination of these to assuage the extent of acute ischemic injury and impede the onset of heart failure pursuant to myocardial remodeling. 
Here we present the methods and materials used to reliably perform this microsurgery and the modifications involved for temporary (with reperfusion) or permanent coronary artery occlusion studies as well as intramyocardial injections. The effects on the heart that can be seen during the procedure and at the termination of the experiment in addition to histological evaluation will verify efficacy. 
Briefly, surgical preparation involves anesthetizing the mice, removing the fur on the chest, and then disinfecting the surgical area. Intratracheal intubation is achieved by transesophageal illumination using a fiber optic light. The tubing is then connected to a ventilator. An incision made on the chest exposes the pectoral muscles which will be cut to view the ribs. For ischemia/reperfusion studies, a 1 cm piece of PE tubing placed over the heart is used to tie the ligature to so that occlusion/reperfusion can be customized. For intramyocardial injections, a Hamilton syringe with sterile 30gauge beveled needle is used. When the myocardial manipulations are complete, the rib cage, the pectoral muscles, and the skin are closed sequentially. Line block analgesia is effected by 0.25% marcaine in sterile saline which is applied to muscle layer prior to closure of the skin. The mice are given a subcutaneous injection of saline and placed in a warming chamber until they are sternally recumbent. They are then returned to the vivarium and housed under standard conditions until the time of tissue collection. At the time of sacrifice, the mice are anesthetized, the heart is arrested in diastole with KCl or BDM, rinsed with saline, and immersed in fixative. Subsequently, routine procedures for processing, embedding, sectioning, and histological staining are performed. 
Nonsurgical intubation of a mouse and the microsurgical manipulations described make this a technically challenging model to learn and achieve reproducibility. These procedures, combined with the difficulty in performing consistent manipulations of the ligature for timed occlusion(s) and reperfusion or intramyocardial injections, can also affect the survival rate so optimization and consistency are critical.

Numerous genetic manipulations and/or intramyocardial injections of genes, proteins, cells, and/or biomaterials are superimposed upon the dimension of time in studies of acute ischemia/ reperfusion injury and chronic remodeling in mice. This video illustrates the microsurgical procedures for ischemia/reperfusion, permanent coronary artery ligation, and intramyocardial injection studies.

心筋梗塞のマウスモデルにおける冠動脈結紮および心筋内注入

Mouse models are a valuable tool for studying acute injury and chronic remodeling of the myocardium in vivo.  With the advent of genetic modifications to ...

Modified Technique for Coronary Artery Ligation in Mice

Myocardial infarction (MI) is one of the most important causes of mortality in humans1-3. In order to improve morbidity and mortality in patients with MI we need better knowledge about pathophysiology of myocardial ischemia. This knowledge may be valuable to define new therapeutic targets for innovative cardiovascular therapies4. Experimental MI model in mice is an increasingly popular small-animal model in preclinical research in which MI is induced by means of permanent or temporary ligation of left coronary artery (LCA)5. In this video, we describe the step-by-step method of how to induce experimental MI in mice.
The animal is first anesthetized with 2% isoflurane. The unconscious mouse is then intubated and connected to a ventilator for artificial ventilation. The left chest is shaved and 1.5 cm incision along mid-axillary line is made in the skin. The left pectoralis major muscle is bluntly dissociated until the ribs are exposed. The muscle layers are pulled aside and fixed with an eyelid-retractor. After these preparations, left thoracotomy is performed between the third and fourth ribs in order to visualize the anterior surface of the heart and left lung. The proximal segment of LCA artery is then ligated with a 7-0 ethilon suture which typically induces an infarct size ~40% of left ventricle. At the end, the chest is closed and the animals receive postoperative analgesia (Temgesic, 0.3 mg/50 ml, ip). The animals are kept in a warm cage until spontaneous recovery.

The surgical procedure used to induce experimental myocardial infarction in mice begins with left thoracotomy between the third and the fourth ribs in order to visualize the anterior surface of the heart and left lung. The left coronary artery is ligated, the chest is closed and the mouse is allowed to recover spontaneously.

マウスにおける冠動脈結紮のために修飾されたテクニック

Myocardial infarction (MI) is one of the most important causes of mortality in humans1-3. In order to improve morbidity and mortality in patients with MI ...

Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research

The vascular endothelium is a monolayer of cells that cover the interior of blood vessels and provide both structural and functional roles. The endothelium acts as a barrier, preventing leukocyte adhesion and aggregation, as well as controlling permeability to plasma components. Functionally, the endothelium affects vessel tone.
Endothelial dysfunction is an imbalance between the chemical species which regulate vessel tone, thombroresistance, cellular proliferation and mitosis. It is the first step in atherosclerosis and is associated with coronary artery disease, peripheral artery disease, heart failure, hypertension, and hyperlipidemia.
The first demonstration of endothelial dysfunction involved direct infusion of acetylcholine and quantitative coronary angiography. Acetylcholine binds to muscarinic receptors on the endothelial cell surface, leading to an increase of intracellular calcium and increased nitric oxide (NO) production. In subjects with an intact endothelium, vasodilation was observed while subjects with endothelial damage experienced paradoxical vasoconstriction.
There exists a non-invasive, in vivo method for measuring endothelial function in peripheral arteries using high-resolution B-mode ultrasound. The endothelial function of peripheral arteries is closely related to coronary artery function. This technique measures the percent diameter change in the brachial artery during a period of reactive hyperemia following limb ischemia.
This technique, known as endothelium-dependent, flow-mediated vasodilation (FMD) has value in clinical research settings. However, a number of physiological and technical issues can affect the accuracy of the results and appropriate guidelines for the technique have been published. Despite the guidelines, FMD remains heavily operator dependent and presents a steep learning curve. This article presents a standardized method for measuring FMD in the brachial artery on the upper arm and offers suggestions to reduce intra-operator variability.

Endothelial dysfunction is associated with numerous disease states and is predictive of adverse cardiovascular events in humans. Flow-mediated vasodilation (FMD) is a non-invasive ultrasound method of evaluating endothelial function. Methodological choices and operator experience may affect results. A systematic approach to FMD in human studies is discussed here.

臨床研究における上腕動脈の内皮依存血流依存性血管拡張の超音波評価

The vascular endothelium is a monolayer of cells that cover the interior of blood vessels and provide both structural and functional roles. The ...

Permanent Ligation of the Left Anterior Descending Coronary Artery in Mice: A Model of Post-myocardial Infarction Remodelling and Heart Failure

Heart failure is a syndrome in which the heart fails to pump blood at a rate commensurate with cellular oxygen requirements at rest or during stress. It is characterized by fluid retention, shortness of breath, and fatigue, in particular on exertion. Heart failure is a growing public health problem, the leading cause of hospitalization, and a major cause of mortality. Ischemic heart disease is the main cause of heart failure.
Ventricular remodelling refers to changes in structure, size, and shape of the left ventricle. This architectural remodelling of the left ventricle is induced by injury (e.g., myocardial infarction), by pressure overload (e.g., systemic arterial hypertension or aortic stenosis), or by volume overload. Since ventricular remodelling affects wall stress, it has a profound impact on cardiac function and on the development of heart failure. A model of permanent ligation of the left anterior descending coronary artery in mice is used to investigate ventricular remodelling and cardiac function post-myocardial infarction. This model is fundamentally different in terms of objectives and pathophysiological relevance compared to the model of transient ligation of the left anterior descending coronary artery. In this latter model of ischemia/reperfusion injury, the initial extent of the infarct may be modulated by factors that affect myocardial salvage following reperfusion. In contrast, the infarct area at 24 hr after permanent ligation of the left anterior descending coronary artery is fixed. Cardiac function in this model will be affected by 1) the process of infarct expansion, infarct healing, and scar formation; and 2) the concomitant development of left ventricular dilatation, cardiac hypertrophy, and ventricular remodelling.
Besides the model of permanent ligation of the left anterior descending coronary artery, the technique of invasive hemodynamic measurements in mice is presented in detail.

Heart failure is the leading cause of hospitalization and a major cause of mortality. A model of permanent ligation of the left anterior descending coronary artery in mice is applied to investigate ventricular remodelling and cardiac dysfunction post-myocardial infarction. The technique of invasive hemodynamic measurements in mice is presented.

マウスの左前下冠動脈の動脈の常設ライゲーション：心筋梗塞後のリモデリングおよび心不全のモデル

Heart failure is a syndrome in which the heart fails to pump blood at a rate commensurate with cellular oxygen requirements at rest or during stress. It ...

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ischemia and infarction in children. If left untreated, it results in a 90% mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic subendocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death. The average age of life-threatening presentation is 33 years and of sudden cardiac death 31 years. Therefore, surgical correction is highly recommended as soon as the diagnosis is made, regardless of age. In adult-type ALCAPA originating from the right-facing sinus of the pulmonary artery, direct re-implantation of the ALCAPA into the aorta is the more physiologically sound repair technique to re-establish the dual-coronary perfusion system and is recommended. This protocol describes the technique of direct re-implantation of adult-type ALCAPA into the aorta.

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

Surgical correction of ALCAPA is highly recommended, regardless of age or the degree of intercoronary collateralization. This protocol presents a technique for the direct re-implantation of adult-type ALCAPA into the aorta to re-establish the dual-coronary perfusion. Whenever feasible, direct re-implantation is preferred to other surgical correction techniques.

肺動脈から左冠状動脈の異常原点と成人における大動脈内に左冠状動脈の直接再注入（ALCAPA）

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ...

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via recanalization of the coronary artery is the most effective strategy for reducing the size of ischemic myocardium. The coronary microvasculature cannot be visualized and imaged&#160;in vivo, but there are several invasive and noninvasive techniques that can be used to assess parameters which depend directly on coronary microvascular function. The endothelial function after ischemia reperfusion can be assessed also at the level of the coronary circulation via the coronary flow reserve (CFR).&#160;In this study, peak velocity of left anterior descending (LAD) coronary arteries was measured in rats in vivo via Transthoracic Doppler Echocardiography during resting and stress challenge (induced by Dobutamine). A normal heart can increase its coronary blood flow up to four times above the resting values during stress induction. Following ischemia reperfusion, we found a significantly diminished CFR, which can be used as a marker of coronary microvascular dysfunction. CFR has opened a window on the importance of microvascular dysfunction and has been shown to predict cardiovascular risk independent of whether the severe obstructive disease is present.

Coronary flow reserve (CFR), is defined as the ratio of maximal coronary blood flow to the resting coronary blood flow. We present a protocol for evaluating CFR in rats via ultrasound, which offers the opportunity to predict cardiovascular risk factors in the absence of obstructive coronary disease.

ラットにおける心筋虚血再灌流後の冠動脈流量の評価

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via ...

Murine Myocardial Infarction Model using Permanent Ligation of Left Anterior Descending Coronary Artery

Myocardial infarction (MI) and acute coronary diseases are among the most prominent causes of death in population with western lifestyle. The murine models of MI with permanent ligation of left-anterior descending (LAD) coronary artery closely mimics MI in humans. Murine models benefit from the extensive genetic engineering available nowadays. Here we propose a reproducible murine surgical model of myocardial infarction by permanent LAD coronary ligation. Our technique comprises anesthesia with ketamine/xylazine that can be rapidly reversed by administration of an antagonist, intubation without tracheotomy for mechanical-assisted ventilation, ventilation with application of extrinsic positive end-expiratory pressure (PEEP) to avoid alveolar collapse, a thoracotomy method limiting to the minimum surgical lesions made to skeletal muscles, and lung inflation without thoracentesis. This method is sparsely invasive, reproducible and reduces post-surgery mortality and complications.

Herein we describe a surgical procedure showing how to achieve permanent ligation of the left-anterior descending coronary artery in mice. This model is of high relevance to investigate the pathophysiology of myocardial infarction and the concomitant biological processes.

左前皮下冠動脈の永久的なライゲーションを用いたマウス心筋梗塞モデル

Myocardial infarction (MI) and acute coronary diseases are among the most prominent causes of death in population with western lifestyle. The murine ...

In Vitro Model of Coronary Angiogenesis

Here, we describe an in vitro culture assay to study coronary angiogenesis. Coronary vessels feed the heart muscle and are of clinical importance. Defects in these vessels represent severe health risks such as in atherosclerosis, which can lead to myocardial infarctions and heart failures in patients. Consequently, coronary artery disease is one of the leading causes of death worldwide. Despite its clinical importance, relatively little progress has been made on how to regenerate damaged coronary arteries. Nevertheless, recent progress has been made in understanding the cellular origin and differentiation pathways of coronary vessel development. The advent of tools and technologies that allow researchers to fluorescently label progenitor cells, follow their fate, and visualize progenies in vivo have been instrumental in understanding coronary vessel development. In vivo studies are valuable, but have limitations in terms of speed, accessibility, and flexibility in experimental design. Alternatively, accurate in vitro models of coronary angiogenesis can circumvent these limitations and allow researchers to interrogate important biological questions with speed and flexibility. The lack of appropriate in vitro model systems may have hindered the progress in understanding the cellular and molecular mechanisms of coronary vessel growth. Here, we describe an in vitro culture system to grow coronary vessels from the sinus venosus (SV) and endocardium (Endo), the two progenitor tissues from which many of the coronary vessels arise. We also confirmed that the cultures accurately recapitulate some of the known in vivo mechanisms. For instance, we show that the angiogenic sprouts in culture from SV downregulate COUP-TFII expression similar to what is observed in vivo. In addition, we show that VEGF-A, a well-known angiogenic factor in vivo, robustly stimulates angiogenesis from both the SV and Endo cultures. Collectively, we have devised an accurate in vitro culture model to study coronary angiogenesis.

In vitro models of coronary angiogenesis can be utilized for the discovery of the cellular and molecular mechanisms of coronary angiogenesis. In vitro explant cultures of sinus venosus and endocardium tissues show robust growth in response to VEGF-A and display a similar pattern of COUP-TFII expression as in vivo.

冠動脈血管新生のインビトロモデル

Here, we describe an in vitro culture assay to study coronary angiogenesis. Coronary vessels feed the heart muscle and are of clinical importance. Defects ...

Echocardiographic Characterization of Left Ventricular Structure, Function, and Coronary Flow in Neonate Mice

Echocardiography is a non-invasive procedure that enables the evaluation of structural and functional parameters in animal models of cardiovascular disease and is used to assess the impact of potential treatments in preclinical studies. Echocardiographic studies are usually conducted in young adult mice (i.e., 4-6 weeks of age). The evaluation of early neonatal cardiovascular function is not usually performed because of the small size of the mouse pups and the associated technical difficulties. One of the most important challenges is that the short length of the pups&#39; limbs prevents them from reaching the electrodes in the echocardiography platform. Body temperature is the other challenge, as pups are very susceptible to changes in temperature. Therefore, it is important to establish a practical guide for performing echocardiographic studies in small mouse pups to help researchers detect early pathological changes and study the progression of cardiovascular disease over time. The current work describes a protocol for performing echocardiography in mouse pups at the early age of 7 days old. The echocardiographic characterization of cardiac morphology, function, and coronary flow in neonatal mice is also described.

The present protocol describes the echocardiographic assessment of left ventricular morphology, function, and coronary blood flow in 7-day old neonate mice.

新生児マウスにおける左心室構造、機能、冠動脈流の心エコー特性評価

Echocardiography is a non-invasive procedure that enables the evaluation of structural and functional parameters in animal models of cardiovascular ...