Document Detail


In vivo detection of myocardial ischemia in pigs using visible light spectroscopy.
MedLine Citation:
PMID:  19299784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Monitoring tissue oxygenation (StO(2)) by visible light spectroscopy (VLS) can identify tissue ischemia, but its feasibility for detecting myocardial ischemia is not known. We hypothesized that VLS can reliably detect changes in myocardial StO(2) in pigs subjected to acute regional or global myocardial ischemia. METHODS: In 11 pigs, regional myocardial ischemia was created by ligation of left anterior descending artery (LAD). Myocardial StO(2) was determined from the ischemic and nonischemic left ventricular (LV) regions and compared to coronary venous saturations. Myocardial function was assessed by echocardiography. In six pigs, LV-StO(2) was measured during cardiopulmonary bypass (CPB), after cardioplegic cardiac arrest, and during CPB with inadequate myocardial protection. Additionally, right ventricular (RV)- and LV-StO(2) were assessed during acute RV pressure overload from pulmonary artery (PA) banding. RESULTS: StO(2) baselines in pigs undergoing LAD occlusion were similar in the ischemic and nonischemic myocardium (70% +/- 8% vs 74% +/- 5%). After LAD ligation, StO(2) rapidly declined (30 s: 59% +/- 8%; 1 min:50 +/- 9; 5 min:42% +/- 4%; P < 0.05) in the ischemic myocardium. Decreases in StO(2) correlated with coronary venous saturations (r = 0.88) and were associated with myocardial dysfunction. In pigs undergoing CPB, LV-StO(2) remained unchanged with initiation of CPB or after cardioplegic cardiac arrest, but LV ischemia was detected by StO(2) after aortic cross-clamp without adequate myocardial protection. Similarly, PA banding resulted in a profound decrease of RV-StO(2) from 69% +/- 6% to 52% +/- 7% (P < 0.05) with recovery after PA release. CONCLUSIONS: VLS is a reliable method of detecting alterations in myocardial StO(2) and can be a useful monitor for rapid identification of myocardial ischemia.
Authors:
Jonathan K Ho; Oliver J Liakopoulos; Ryan Crowley; Aaron B Yezbick; Elizabeth Sanchez; Kalyanam Shivkumar; Aman Mahajan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  108     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-20     Completed Date:  2009-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1185-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Aorta / surgery
Cardiopulmonary Bypass / adverse effects
Coronary Vessels / surgery
Disease Models, Animal
Echocardiography, Transesophageal
Equipment Design
Feasibility Studies
Heart Arrest, Induced / adverse effects
Hemodynamics
Myocardial Ischemia / diagnosis*,  etiology,  metabolism,  physiopathology,  ultrasonography
Myocardium / metabolism*,  pathology
Oxygen / metabolism*
Predictive Value of Tests
Pulmonary Artery / surgery
Reproducibility of Results
Spectrum Analysis* / instrumentation
Swine
Time Factors
Ventricular Dysfunction, Right / complications,  metabolism
Grant Support
ID/Acronym/Agency:
P01 HL078931/HL/NHLBI NIH HHS; R01-HL084261/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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


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