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Giorgio Arpesella
Piero M. Mikus
Franco Dozza
Giuseppe Marinelli
Angelo Pierangeli
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Ann Thorac Surg 1998;66:1983-1990
© 1998 The Society of Thoracic Surgeons

Original Articles

Activity–rest stimulation of latissimus dorsi for cardiomyoplasty: 1-year results in sheep

Giorgio Arpesella, MDa, Ugo Carraro, MDb, Piero M. Mikus, MDa, Franco Dozza, MDa, Pierloca Lombardi, MDa, Giuseppe Marinellia, Sandra Zampieri, SciBiolb, Abdul H. El Messlemanib, Katia Rossini, SciBiolb, Angelo Pierangeli, MDa

a Cardiovascular Surgery, The S. Orsola Hospital, University of Bologna, Bologna, Italy
b C.N.R. Unit for Muscle Biology and Physiopathology and Department of Biomedical Sciences, University of Padova, Padova, Italy

Accepted for publication June 3, 1998.

Address reprint requests to Dr Carraro, Department of Biomedical Sciences, University of Padova, Viale Colombo, 3, I-35121 Padova, Italy

Background. In dynamic cardiomyoplasty electrostimulation achieves full transformation of the latissimus dorsi (LD); therefore, its slowness limits the systolic support. Daily activity–rest could maintain partial transformation of the LD.

Methods. Sheep LD were burst-stimulated either 10 or 24 hours/day. Before and 2, 4, 6, and 12 months after stimulation, LD power output, fatigue resistance, and tetanic fusion frequency were assessed. Latissimus dorsi were biopsied at 6 months, and sheep sacrificed at 12 months.

Results. After 1 year of 10 hours/day stimulation LD was substantially conserved and contained large amounts of fast type myosin. From 2 months to 1 year of stimulation the power per muscle of the daily rested LD was greater than that of the left ventricle, being three to four times higher than in the 24-hour/day stimulation.

Conclusions. If extended to humans, these results could be the rationale for the need of a cardiomyostimulator, whose discontinuous activity could offer to patients the long-standing advantage of a faster and powerful muscle contraction.




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