Document Detail

Hemodynamic effects in acute cardiomyoplasty of different wrapped muscle activation times as measured by pressure-volume relations.
MedLine Citation:
PMID:  8889882     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Correct timing of mechanical interaction between wrapped latissimus dorsi muscle (LDM) and the heart during cardiac systole has been poorly understood and remains a controversial issue. Therefore, left ventricular pressure-volume relations were analyzed in acute cardiomyoplasty while changing the synchronization delays. METHODS: Effects of different delays between the sensed cardiac R wave and wrapped muscle contraction were studied in goats submitted to acute left cardiomyoplasty. Conductance and micromanometer catheters were used to evaluate hemodynamics. Systolic contribution of the wrapped muscle was studied in preassisted and assisted beats, whereas diastolic effects were studied in assisted and postassisted beats. RESULTS: At best settings, cardiomyoplasty resulted in a significant (p < 0.05) increase in left ventricular ejection fraction (from 42.2 +/- 9.2 to 56.7% +/- 13%), in stroke work (from 2769 +/- 1140 to 4271 +/- 1717 gm/m2), in dP/dt (from 1185 +/- 342 to 1510 +/- 285 mmHg/sec), in end-systolic pressure (from 93.5 +/- 22.5 mmHg to 97.3 +/- 22.3 mmHg), and in peak ejection rate (from 282 +/- 64 to 533 +/- 241 mL/sec). Stroke volume showed a mean increase of 35% (from 42.2 +/- 9.9 mL to 56.9 +/- 20.1 mL) during assisted beats. Diastolic function was not substantially impaired at optimal stimulation delay. Incorrect timing of LD contraction resulted in suboptimal improvement or no change in comparison with unassisted hemodynamics. CONCLUSIONS: Our study documents support of cardiac performance by LDM. Incorrect timing of heart/wrapped muscle interaction led to suboptimal hemodynamic results. Muscle contraction timing is an important factor in cardiomyoplasty outcome.
R Lorusso; F van der Veen; J J Schreuder; G Bolotin; H G Kaulbach; R Frietman; J Habets; T van der Nagel; H J Wellens
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  11     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    1996 May-Jun
Date Detail:
Created Date:  1997-02-12     Completed Date:  1997-02-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  217-25     Citation Subset:  IM    
Department of Cardiology, Academic Hospital Maastricht, The Netherlands.
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MeSH Terms
Diastole / physiology
Hemodynamics / physiology*
Muscle Contraction / physiology
Stroke Volume / physiology
Systole / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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