Ventricular Section Research Articles

Synchronized coronary venous tetroperfusion: Prompt improvement of left ventricular function in experimental myocardial ischemia

The effect of synchronized coronary venous retroperfusion of arterial blood on cardiac function after experimental coronary occlusion was examined by two-dimensional echocardiography. In 18 closed chest anesthetized dogs, the proximal left anterior descending coronary artery was occluded for 6 hours with an intracoronary balloon catheter. Eight of these animals served as untreated controls. Ten were treated with synchronized retroperfusion initiated 30 minutes after occlusion, and treatment was interrupted for 5 minutes at 1 hour after occlusion for study of the rapidity of retroperfusion response. Quantitative echographic analysis yielded global ejection fraction and regional indexes of contraction in a low left ventricular short-axis section, including segmental systolic area change, systolic wall thickening and end-diastolic wall thickness. At 6 hours after occlusion, ejection fraction had decreased from 50.7 +/- 4.9% to 28.1 +/- 7.7% (mean +/- standard deviation) in control dogs, but was significantly (p less than 0.01) less depressed in treated dogs (from 55.9 +/- 5.2 to 41.8 +/- 9.3%). The ischemic zone fractional area change at 30 minutes of occlusion exhibited a marked depression in both groups, after which the dysfunction persisted in the control dogs, but was largely reversed with retroperfusion from 6.0 +/- 6.5 to 35.9 +/- 15.9% at 6 hours of occlusion (p less than 0.01). Brief interruption of retroperfusion 1 hour after occlusion reduced ischemic zone fractional area change from 33.0 +/- 14.9 to 12.2 +/- 9.5% (p less than 0.01). This depression was promptly reversed to 33.6 +/- 12.2% when retroperfusion was resumed. Segmental wall thickening followed a similar trend.(ABSTRACT TRUNCATED AT 250 WORDS)

Prostaglandin E1coronary venous retroperfusion in acute myocardial ischemia: Effects on regional left ventricular function and infarct size

Prostaglandin E1 was administered by means of coronary venous synchronized retroperfusion and the effectiveness of the combined (prostaglandin-retroperfusion) system was examined during acute myocardial ischemia in 10 closed chest anesthetized dogs. Such treatment was administered between 30 minutes and 3 hours after occlusion of the proximal left anterior descending coronary artery. An equivalent series of 10 dogs with arterial blood retroperfusion alone and 9 untreated dogs served as control subjects. Standardized two-dimensional echocardiographic measurements of global and regional left ventricular function were performed in five short-axis cross sections. The global low left ventricular section and its profoundly ischemic anterolateral region exhibited distinctly improved systolic fractional area changes as a result of the prostaglandin E1 retroperfusion treatment between 30 minutes and 3 hours after occlusion (22.9 +/- 1.5 to 41.2 +/- 4.0% and 1.8 +/- 3.6 to 29.4 +/- 5.6%, respectively). In contrast, further deterioration in function was noted during an untreated equivalent coronary occlusion period (16.3 +/- 2.7 to 10.0 +/- 3.3% and 12.6 +/- 6.1 to 4.1 +/- 6.9%). Although arterial blood retroperfusion alone provided distinct benefits in the ischemic region of a midpapillary echo section (from 13.4 +/- 3.9 to 32.1 +/- 10.4%, p less than 0.05), no improvements were observed in profoundly jeopardized segments at the low left ventricular level (5.6 +/- 6.0 to 0.9 +/- 5.7%). Triphenyltetrazolium chloride delineation of infarction revealed significant myocardial salvage with prostaglandin E1 retroperfusion as compared with findings in untreated control dogs (3.7% +/- 1.3% of the left ventricle versus 9.3 +/- 1.9%, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Left ventricular ejection fraction during cardiac surgery: a two-dimensional echocardiographic study.

Although long-term effects have been studied, the immediate effect of surgery for acquired heart disease on left ventricular function is not well defined. Accordingly, 44 adults with acquired heart disease underwent intraoperative two-dimensional echocardiography with a gas-sterilized transducer before and immediately after cardiopulmonary bypass. Ejection fraction was measured by short-axis area change at the maximum left ventricular cross section (SAAC-EF) and also by a method using multiple sections. Correction of both mitral and aortic regurgitation produced a significant intraoperative decrease in ejection fraction from 0.49 +/- 19 (SD) to 0.32 +/- 0.16 (p less than .02) and from 0.41 +/- 0.13 to 0.30 +/- 0.17 (p less than .0005), respectively. Relief of aortic stenosis and mitral stenosis resulted in an intraoperative increase in ejection fraction from 0.45 +/- 0.10 to 0.55 +/- 0.09 (p less than .02) and from 0.41 +/- 0.05 to 0.50 +/- 0.07 (p less than .05), respectively. Ejection fraction after coronary artery bypass grafting was unchanged. Preload (end-diastolic area) was significantly decreased after correction of aortic regurgitation (p less than .02) but unchanged in other lesions. We conclude that (1) correction of pure mitral and aortic valvular lesions produces characteristic alterations in ejection fraction in the immediate postoperative period; (2) with the possible exception of patients with aortic regurgitation, the observed change in ejection fraction does not appear to reflect changes in preload; (3) noninvasive assessment of left ventricular function by two-dimensional echocardiography during cardiac surgery appears feasible and could provide data important for clinical decision making in the early postoperative period.

Histoenzymological study of myocardial ATPase activity in experimental infarction in the rat.

Histoenzymological techniques were used to examine ATPase activity in rat heart muscle fibres after experimental infarction. 25 hours after coronary ligation, ATPase activity in all ventricular section fibres was high, homogeneous at pH 9.4, sections. 48 hours after ligation, necrotic ventricular fibres appeared, leaving only a thin layer of fibres which had apparently preserved their myofibrillar ATPase. These results indicate that, unlike mitochondrial enzyme activity, myofibrillar ATPase activity is relatively resistant to ischaemia.

Demonstration of alpha-adrenergic coronary control in different layers of canine myocardium by regional myocardial sympathectomy

The direct effects of sympathetic coronary innervation in conscious dogs were analyzed by comparison of myocardial blood flow in a sympathectomized section of the left ventricle with blood flow in another section of the same ventricle with intact sympathetic innervation. Regional myocardial sympathectomy was accomplished by a protocol of intracoronary application of 6-hydroxydopamine (6-OHDA). Regional adrenergic nerve function was checked by studies on accumulation, retention and stimulus-induced release of labelled norepinephrine together with studies on regional ventricular contractility during stellate ganglion stimulation. These tests demonstrated complete sympathectomy in the 6-OHDA-treated section and an unimpaired adrenergic nerve function in the untreated control section. In these dogs at rest, myocardial blood flow (MBF) was 66±14 ml/min·100 g in the left ventricular control section and 108±16 ml/min·100 g in the 6-OHDA-treated section. Transmural distribution of MBF was similar in these two sections: subendocardial MBF/subepicardial MBF was 1.28±0.17 in the control section and 1.36±0.12 in the 6-OHDA-treated section. Application of 1.0 mg/kg propranolol i.v. did not modify MBF and its distribution in either section. Following 1.0 mg/kg phentolamine i.v., MBF in the control section approached that in the 6-OHDA-treated sympathectomized section. These results demonstrate that a substantial α-adrenergic constrictive coronary tone is operative in the ventricular control section in these conscious dogs at rest, which is of similar magnitude in different layers of the left ventricular wall.

Plane-strain finite-element analysis of reconstructed diastolic left ventricular cross section

The true shapes of cross sections of isolated left ventricles reconstructed from multiplanar roentgenographic recordings are analyzed using the finite-element method based on plane—strain theory. The proposed cylindrical model of the left ventricle permits variations of the stresses not only transversely throughout the ventricular walls but also circumferentially around the epicardial and endocardial surfaces to be evaluated. Numerical results are presented for cross sections at the midplane between the base and apex of the left ventricle during early and end diastole. For the anterior and posterior walls of the left ventricle, the maximum circumferential stresses are found to occur on the endocardial surface, whereas for the septal and free walls of the left ventricle, the maximum circumferential stresses occur on the epicardial surface with compressive circumferential stresses often developing on the endocardial surface.