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Forgotten driving forces in right heart failure (Part II): experimental study.
MedLine Citation:
PMID:  23284105     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Cardiac-assist devices for right ventricular failure remain controversial with poor results. This study evaluated a pulsatile cardiac-assist device in an acute right ventricular failure model vs. current therapies. Materials and methods: Pulmonary regurgitation was created in 12 piglets by valve avulsion and external transfixation of 2 pulmonary artery cusps suspended to the pulmonary arterial wall. The piglets were divided into 2 treatment groups: a pulsatile group P and a non-pulsatile group NP. Management started when severe right ventricular failure was observed (48.1 ± 24.5 min). In group P, pulsatile trousers driven by a pneumatic generator were pulsated intermittently at 40 beats·min(-1). Group NP was treated with oral tadalafil 1 mg·kg(-1), intravenous fluids, and adrenaline 0.3 μg·kg(-1). After 1 h of therapy, cardiac output was significantly better in group P than group NP (1 ± 0.2 vs. 0.7 ± 0.2 L·min(-1)). Mean right ventricular pressure (16 ± 6 vs. 24 ± 2 mm Hg) and pulmonary arterial pressure (22 ± 1 vs. 31 ± 2 mm Hg) were lower in group P. Vascular resistances indices were lower in group P than group NP: pulmonary resistance index was 174 ± 60 vs. 352 ± 118 dyne·sec·cm(-5)·kg(-1); systemic resistance index was 611 ± 70 vs. 1215 ± 315 dyne·sec·cm(-5)·kg(-1). Western-blot analysis showed higher endogenous NO synthase expression in group P pulmonary arteries. Conclusions: The pulsatile suit can be used safely as a noninvasive cardiac-assist device in acute right ventricular failure. This represents a cost-effective nearly physiological method, suitable for adults and children.
Authors:
Sayed Nour; Gang Dai; Qinmei Wang; Fei Wang; Juan Carlos Chachques; Guifu Wu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  20     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  England    
Other Details:
Languages:  eng     Pagination:  646-57     Citation Subset:  IM    
Affiliation:
nourmd@mac.com.
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