Strategies for Examining Dynamic Cardiomyoplasty

Typically, in cardiomyoplasty (CMP) experimental studies, a new intervention is examined only after 3 months of latissimus dorsi muscle (LDM) training. We believe that this has been a major mistake. In our approach, we sequentially measured the effects of LDM stimulation in CMP. Our experimental results showed that the effects of LDM stimulation were variable, and that this variability was present shortly after surgery. Accordingly, we tried a number of approaches (LDM training before surgery, LDM stimulation early after surgery, wrapping the LDM in a Gore-Tex membrane, etc.), all of which failed. Our last approach was to try vascular delay, and to evaluate LV function in a terminal study 2 weeks after CMP surgery. Preconditioning the LDM with vascular delay resulted in improving performance of the LDM with consistent increases in LV hemodynamics.