| 이상록, 정명호, 홍영준, 윤남식, 황선호, 김주한, 홍서나, 김계훈, 박형욱, 안영근, 조정관, 박종춘, 강정채, 박옥규 |
Background: There is an increasing evidence to suggest the trimetazidine (TMZ) has the ability to improve ischemic heart failure by way of the optimization of energy metabolism. The aim of this study was to examine the changes of enhancement pattern using two phase contrast enhanced ECG gated multidetector computed tomography (MDCT) by TMZ in porcine myocardial infarction model.
Methods: The First Experiment: Porcine myocardial infarction model was made by balloon occlusion of the left anterior descending coronary artery. We randomized into two groups: group I (n=5: aspirin only), group II (n=7: aspirin plus 1 mg/kg TMZ for 4 weeks). The Second Experiment: Echocardiography and functional study by MDCT including ejection fraction (EF, %), end-systolic volume (ESV, ml) and end-diastolic volume (EDV, ml) were measured at 28 days after the first experiment. Three enhancement pattern including early arterial phase defect (ED), 5-min late enhancement (LE) and residual defect (RD) were also investigated and that was described as class I [ED(-), RD (-), LE (±)], class II [ED(+), RD (-), LE (+)], and class III [ED(+), RD (+), LE (+)]. Histopathologic examination was performed after sacrifice.
Results: At 28 days, EF by echocardiography was similar between two groups (group I: 50.6±7.2 & vs. group II: 46.9±8.1 %, p=NS). Functional study by MDCT was also similar between two groups (group I: EF:ESV:EDV=47.8±12.9:39.6±18.7:79.2±34.9, group II: EF:ESV:EDV= 49.8±13.2:43.8±23.1:82.8±24.6, p=NS). Percent wall thickness was similar (62.2±18.3 % vs. 64.9±10.5 %, p=NS), but the enhancement pattern was different (group I-class I: class II: class III = 0(0%):1(20%):4(80%), group II–class I: class II: class III = 0(0%):2(28.6%):5(71.4%), p<0.05). The volume of tissue that lacking triphenyl tetrazolium chloride was similar between two groups (8.0±2.5 % vs. 7.3±2.6, p=NS).
Conclusion: TMZ administration made different enhancement patterns by MDCT in porcine myocardial infarction model, which suggested the role of TMZ reducing irreversible area of infracted myocardium.
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