Reduction of infarct size induced by pressure-controlled intermittent coronary sinus occlusion

Möhl, Werner; Glogar, Dietmar; Mayr, Harald; Losert, Udo; Sochor, Heinz; Pachinger, Othmar; Kaindl, F; Wolner, Ernst

doi:10.1016/0002-9149(84)90526-5

Cited by 91 publications

(31 citation statements)

References 14 publications

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“…Arterial blood gases were monitored frequently and remained at appropriate levels (pH = 7.36 to 7.46, Pco2 = 35 to 48, Po2 = 87 to 138 mm Hg) throughout the experiment. 1404 FIGURE 1. A schematic view of the experimental preparation.…”

Section: Methodsmentioning

confidence: 99%

Effect of pressure-controlled intermittent coronary sinus occlusion on pacing-induced myocardial ischemia in domestic swine.

et al. 1988

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This study tested the hypothesis that pressure-controlled intermittent coronary sinus occlusion (PICSO) would be useful in ameliorating myocardial ischemia under conditions characterized by preserved, but reduced (relative to demand), myocardial blood flow. Studies were conducted in closed-chest, sedated domestic swine prepared with an artificial stenosis that reduced luminal diameter of the animal's left anterior descending coronary artery by 80%. Measurements of hemodynamics, regional myocardial blood flow, and oxygen, lactate, and nucleoside metabolism were obtained in 10 animals (1) before placement of stenosis, (2) 30 min after insertion of stenosis, (3) after 30 and 60 min of PICSO, and (4) 30 min after discontinuation of PICSO. Two groups of control animals were studied to observe the natural history of metabolic markers of ischemia. Control group I consisted of four animals studied concurrently and subjected to the same protocol except for the fact that PICSO was not applied. Control group II consisted of eight additional animals studied as a group. A specially designed balloon-tipped catheter positioned in the proximal portion of the animal's great cardiac vein was used to provide PICSO. Heart rate was controlled by atrial pacing (rate, 145 beats/min) through the study. After placement of the stenosis, flow in endocardial and transmural layers distal to the stenosis declined significantly (p<.01) vs control. Application of PICSO failed to increase arterial inflow distal to the stenosis in any myocardial layer. Myocardial aerobic metabolism was adversely affected by stenosis and changed from consumption of lactate, inosine, and hypoxanthine before stenosis to production at 30 min after stenosis. Although PICSO was associated with reduced production and a return toward consumption of lactate, inosine, and hypoxanthine, a similar pattern of changes in lactate, inosine, and hypoxanthine metabolism was observed in control animals over a comparable period of time. In addition, regional myocardial oxygen extraction and consumption were not changed vs poststenosis levels by PICSO. However, in comparison with controls, PICSO did accelerate the rate of resolution of myocardial ischemia as assessed by lactate metabolism. At 30 min of PICSO (or sham) the change vs poststenosis was + 33.6 + 25.0 ,mol/min/100 g in the PICSO but only + 6.7 ± 29.7 in the control group (p =.05). We conclude, therefore, that even though PICSO did not alter the final level of myocardial ischemia under conditions modeled in this study it did accelerate its rate of resolution, an effect that may be beneficial clinically. Circulation 77, No. 6, 1403No. 6, -1413No. 6, , 1988 PREVIOUS EXPERIMENTS in canine preparations of acute myocardial infarction indicate that pressurecontrolled intermittent coronary sinus occlusion (PICSO) may be of value in reducing infarct size' and in improving systolic function in the infarct zone.2 The mechanism(s) responsible for PICSO's beneficial ef-

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Section: Methodsmentioning

confidence: 99%

Effect of pressure-controlled intermittent coronary sinus occlusion on pacing-induced myocardial ischemia in domestic swine.

et al. 1988

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“…We use R m to denote the ratio of the ischaemic myocardial mass to the total myocardial mass. In this study, a value of 30% is used for Rm, which models the typical ischaemic condition of a canine heart 15 min after its left anterior descending coronary artery has been ligated (MOHL et al, 1984).…”

Section: Complete Canine Cardiovascular Model Including Pumpmentioning

confidence: 99%

Simulation study of the Hemopump as a cardiac assist device

Bai

2002

Med. Biol. Eng. Comput.

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A dynamic model was developed for a Hemopump that withdraws blood from the left ventricle and discharges it to the aorta through a miniature axial-flow pump. Incorporation of the Hemopump model in a previously established model for the canine circulatory system enabled the effects of the Hemopump on various haemodynamic variables of the circulatory system to be studied, and the benefit of the Hemopump to the failing heart was investigated. In addition, the influence of the physiological status of the right ventricle on the Hemopump performances was examined, and the synchronous and non-synchronous operations of the Hemopump were compared. Results verified that the Hemopump assists the failing heart by increasing the oxygen supply, while reducing the oxygen consumption of the heart through a reduction in the workload of the left ventricle. These beneficial effects were enhanced when the pump's rotation speed was increased. When pump speed was increased from 17,000 to 23,000 revolutions min-1, the oxygen supply increased 101%, and the oxygen consumption decreased 60%. However, when the pump rotation speed was too high, the inflow to the pump could be impaired and the pump performance could be negatively affected. Predications from the model were in good agreement with the results previously obtained in animal experiments and in vitro measurements.

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“…Using PICSO we were able to show in a canine model with 6 hours of permanent coronary artery occlusion a 50% infarct size reduction rated against the area at risk and an increase of the occluded coronary artery pressure. These data were corroborated worldwide and a Meta analysis of comparable data with different models of ischemia and reperfusion in different species of experimental animals showed a mean of 30% infarct size reduction [56,57].…”

Section: Werner Mohl MD Phd; Applied Coronary Hemodynamics and Workingmentioning

confidence: 60%

Basic and applied research at the department of cardio-thoracic surgery: work in progress

Ankersmit¹,

Podesser

Aharinejad³

et al. 2008

Wien Klin Wochenschr

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Reduction of infarct size induced by pressure-controlled intermittent coronary sinus occlusion

Cited by 91 publications

References 14 publications

Effect of pressure-controlled intermittent coronary sinus occlusion on pacing-induced myocardial ischemia in domestic swine.

Effect of pressure-controlled intermittent coronary sinus occlusion on pacing-induced myocardial ischemia in domestic swine.

Simulation study of the Hemopump as a cardiac assist device

Basic and applied research at the department of cardio-thoracic surgery: work in progress

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