Abstract
Purpose: Evaluation of myocardial contractility during ventricular assist device (VAD) support is important to recognize the mechanism of myocardial recovery, hut that is difficult because VAD support changes preload and afterload conditions. The left ventricular (LV) end-systolic pressure-dimension relationship (ESPDR) is one of useful load independent indexes of cardiac function. We investigated whether the ESPDR could evaluate regional wall motion during VAD support in goats with severe heart failure after myocardial infarction (MI). Materials and Methods: Six adult goats weighing 65.3 ± 4.2 kg were conducted biventricular bypass with pulsatile VADs paracorporealy. Acute MI was created by ligation of the left anterior descending coronary artery. The ESPDR was measured before MI and after MI using LV pressure and simultaneous short axis dimension of the LV by means of ultrasonic crystals inserted into both sides of the endocardium. The VADs were driven asynchronously with the native heart, and the pumping rate was altered from 60 to 30 bpm at 10 bpm intervals in each sampling period. Results: The slope of ESPDR (Ees) was not altered either by pumping rate or bypass flow rate. The Ees significantly decreased after MI (from 26.0 ± 17.1 mm Hg/mm to 16.2 ± 11.8 mm Hg/mm), and reached to a minimum about two weeks later. Conclusion: We can continuously measure the ESPDR during VAD support and accurately evaluate the regional wall motion of myocardium.
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