Controlled Reperfusion Following Regional Ischemia

Lazar, Harold L.; Wei, Jeng; Dirbas, Frederick M.; Haasler, George B.; Spotnitz, Henry M.

doi:10.1016/s0003-4975(10)63789-7

Cited by 13 publications

(6 citation statements)

References 20 publications

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“…In agreement with findings by Lazar et al [30], obtained by means of invasive measurements in a dog model, we have observed that non-invasive MWI was significantly reduced during TACO compared to baseline values (p<0.001). Similarly, its derived indices as MCW and MWE index were significantly reduced during TACO (p<0.001).…”

Section: Plos Onesupporting

confidence: 93%

“…Indeed, not only the average peak systolic GLS was significantly impaired during ischemia, but also, not surprisingly, PSI was significantly increased during TACO compared to baseline, as consequence of the increased amount of post-systolic thickening occurred in the ischemic myocardium. https://doi.org/10.1371/journal.pone.0244397.g002 In 1987, Lazar et al [30] demonstrated a significant decrease in stroke work index, assessed with invasive measurements of LV Pressure-Volume loops, in 17 dogs when the proximal left anterior descending coronary artery was occluded for 45 minutes.…”

Section: Impairment Of Myocardial Function During Acute Ischemiamentioning

confidence: 99%

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Non-invasive myocardial work is reduced during transient acute coronary occlusion

et al. 2020

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Background During ischemia a close relationship exists between sub-endocardial blood flow and myocardial function. Strain parameters can capture an impairment of regional longitudinal function but are load dependent. Recently, a novel non-invasive method to calculate Myocardial Work (MW) showed a strong correlation with invasive work measurements. Our aim was to investigate the ability of non-invasive MW indices to identify the ischaemic risk area during transient acute coronary occlusion (TACO). Methods and results The study population comprises 50 individuals with critical coronary stenosis (CCS). Echocardiography recordings were obtained before coronary angiography, during TACO and after revascularization to measure global longitudinal strain (GLS), Myocardial Work Index (MWI), Myocardial Constructive Work (MCW), Myocardial Wasted work (MWW), Myocardial work efficiency (MWE). Compared to baseline, we found a significant reduction of GLS (p = 0.005), MWI, MCW and MWE (p<0.001) during TACO. Conclusions The non-invasive measurement of MW parameters is a sensitive and early marker of myocardial ischemia during TACO.

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Section: Plos Onesupporting

confidence: 93%

Section: Impairment Of Myocardial Function During Acute Ischemiamentioning

confidence: 99%

Non-invasive myocardial work is reduced during transient acute coronary occlusion

et al. 2020

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“…On CPB in the research laboratory, 2‐DE revealed 15–30% increases in LVM [1, 2, 40–48]. The magnitude of these changes was surprising but predictable, as described above.…”

Section: Myocardial Water Content and LV Massmentioning

confidence: 82%

“…Calculations improved with image quality as well as better algorithms for LV end‐diastolic volume (EDV), LVM, and geometry in dogs. Multiple observers blinded to the conditions under which 2‐DE was done validated our calculations [1, 2, 40–48]. LVM measurements proved more accurate and reproducible than measurements of LVEDV despite the fact that LVM is defined by the mathematic difference of calculations of the epicardial and endocardial shells.…”

Section: Myocardial Water Content and LV Massmentioning

confidence: 88%

“…Infants and children with congenital heart disease are of particular interest for studies of edema on CPB because the volume and surface area of the CPB circuit is large in relation to the patient’s blood volume, similar to conditions in our earlier studies of edema in dogs [2, 40–48]. Despite efforts to miniaturize CPB circuits [62], inflammation is recognized to be problematic in children [62], and ultrafiltration to remove free water has been advocated after CPB [63].…”

Section: Myocardial Water Content and LV Massmentioning

confidence: 99%

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Ventricular Function in Surgery for Congenital Heart Disease

Spotnitz

2009

World j. surg.

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BACKGROUND The history of measuring myocardial edema by two-dimensional echocardiography and the pathophysiology of myocardial edema are reviewed. METHODS The relevance of this subject to management of children undergoing corrective surgery for single ventricle physiology and tetralogy of Fallot is reviewed. RESULTS Evidence is presented that myocardial edema is an ongoing clinical problem with relevance to management and outcomes. Methods for measuring mass increases noninvasively in the range of 10-25% with increases in myocardial water content on the order of 2-4% are now well established. CONCLUSIONS These methods and advanced animal models replicating conditions of surgery for cyanotic congenital heart disease set the stage for clinical advances in this important area.

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