Regional Myocardial Function in the Presence of Coronary Artery Stenosis and Inotropic Intervention

Abstract

The aim of this study was to examine the effect of an inotropic intervention on regional myocardial function in the presence of a significant stenosis in a coronary artery. During 0.5% halothane anesthesia, intravenous dobutamine (2.5 and 5 micrograms.kg-1.min-1) was administered to eight pigs. A critical constriction was applied to the left anterior descending (LAD) coronary artery and regional myocardial function was determined with the end-systolic pressure-length relationship in the area of distribution of the LAD and left circumflex coronary artery. Infusion of dobutamine was associated with an increase in the end-systolic pressure-length relationship in the left circumflex coronary artery region from 31.81 +/- 7.87 to 81.03 +/- 21.43 mm Hg.mm-1 (X +/- SEM, P = 0.005), whereas function in the LAD coronary artery region did not change significantly (21.78 +/- 3.97 to 21.97 +/- 6.91 mm Hg.mm-1, P = 0.124). Regional stroke work in the left circumflex coronary artery distribution area increased from 124.38 +/- 24.04 to 222.00 +/- 37.83 mm Hg.mm during the administration of 5 micrograms.kg-1.min-1 dobutamine (P = 0.0125). In the LAD coronary artery area, regional stroke work remained at baseline values. Once the constriction was released, the end-systolic pressure-length relationship in the LAD artery segment increased from 21.97 +/- 2.45 to 35.36 +/- 4.55 mm Hg.mm-1 (P = 0.121). These results suggest that hibernation develops in the myocardial segment supplied by a stenotic coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)