Comparative study of left ventricular wall motion and of reperfusion arrhythmias as signs of successful coronary recanalization

Abstract

Myocardial dissynergy and arrhythmia were compared as consequences of reperfusion after controlled ischemia (ligature of the left coronary artery) in fourteen dogs. Echocardiographic contrast agent administered in the aorta and two-dimensional echocardiography enabled images of the perfusion area. Reperfusion was established after 1,2,5,10 and 15 min, and we analyzed the establishment of segmental wall motion (by echocardiography) and the appearance of reperfusion arrhythmias. After occlusion of the left coronary artery, the period for establishment of blood flow was on average, 1.24±0.4 min. When establishment of the coronary flow was accompanied by reperfusion arrhythmias, these developed on average 6.44_2.3 min. after reperfusion minimally 2 min. and maximally 15 min from the end of interruption of the circulation. The establishment of ischemic region motion showed the slowest recovery (12.26_4.4 min). Wall motion of the left ventricle after the short term of occlusion (1.0 min) appeared immediately after the establishment of blood flow. When the period of occlusion was longer (15 min), wall motion was achieved half an hour after reperfusion commenced (33.7 min). Left ventricle wall motion abnormalities are, in most cases, a sign of coronary circulation damage, they appear as a first manifestation of ischemia, but they recover slowest after reperfusion is established. Reperfusion arrhythmias do not always follow reperfusion, and if present, appear before left ventricle segmental wall motion is established