Completed
WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
MOUSE CARDIOVASCULAR PHENOTYPING CORE
REQUEST FOR ISOLATED WORKING HEART SERVICES
For more information contact Toni Gonzales at agonzale@im.wustl.edu (2-8901)
Carla Weinheimer at cweinhei@wustl.edu, or Nanda Sambandam at nsamband@wustl.edu
Return completed form to Toni Gonzales at Box 8086, CSRB NTA Room 810; Fax 362-0186
A.
General Information (please print clearly)
Principal Investigator:
Department/Division:
Phone:
Fax:
Contact Person, Phone, and Pager:
Date of request:
Email:
1.
State specific cardiac metabolic/physiologic question to be addressed: This must be completed
before request will be considered.
2.
3.
4.
5.
6.
Mouse Strain/Mutation/Transgenic to be studied:
Number of Mice:
Grant I.D. number:
___Fund #:
Funding Source/Name______________________
Animal Studies Committee Approval Number:
Animal Studies Committee Approval Date:
B.
Services
Check Services Requested

1. 30 or 60 minute aerobic perfusion:
1. Excise and perfuse hearts for 60 minutes under aerobic condition with different
substrates (depending on the study question) with radio labeled tracers to measure
rates of:
a. glucose oxidation
b. palmitate oxidation
2. Monitor hemodynamics such as peak systolic pressure (with pressure transducer
placed in aortic line), heart rate, cardiac output, and aortic flow.
3. Calculate parameters such as coronary flow (cardiac output – aortic output), cardiac
work (Peak Systolic Pressure  cardiac output), cardiac power (product of developed
pressure and cardiac output), stroke work (cardiac work/heart rate), stroke volume
(cardiac output/heart rate), rate pressure product (Peak systolic pressure  heart rate).
All measurements are done every 10 minutes for 60 minutes. All values are normalized
to dry biventricular wt.
1
Revised: July 17, 2008

2. Ischemia / reperfusion
Ischemia reperfusion involves 30 minutes aerobic perfusion to obtain basal metabolic
and functional measurements, 18 minutes (or less depending on the study) of global
ischemia followed by 40 minutes of reperfusion with oxygenated buffer to obtain
functional and metabolic parameters during recovery.
Steps 1- 3 under ‘60 minute aerobic perfusion’ remain the same. Measurements will be
taken every 10 minutes for 30 minutes during pre-ischemic and for 40 minutes during
post-ischemic periods. No measurements can be taken during ischemia.
C.
1.
2.
3.
4.
Charges
60 minute aerobic perfusion $393 x
Ischemia reperfusion
$419 x _______
30 minute aerobic perfusion $367 x
60 minute non-radioactive perfusion $300 x
D.
1.
2.
Terms
Prior ASC approval must be obtained by investigator.
Investigator is responsible for transferring animals to the Core’s in/out housing facility in the
basement of CSRB (Room 410), and for retrieving all preserved tissue samples at the end of the
study.
Housing costs/per diems are the full responsibility of the investigator (billed by D.C.M.).
Charges may be subject to change as the cost of supplies increase.
3.
4.
(# of mice) =
(# of mice) =
(# of mice) =
(# of mice) =
I agree to follow the terms and conditions described in this application.
I understand the terms and fees for the services and I agree to pay the invoices from The Isolated
Working Heart Core Facility for the services I have requested.
P.I. Signature
Date
Billing contact person
Phone Number
FINAL BILLING STATEMENT
Date IWH perfusion completed
Number of IWH perfusion which were completed in full requested protocol
Amount(s) reduced from request/Reason(s) for reduction
Final Charge
Core Staff Member Initial
2
Revised: July 17, 2008