Author + information
- Received April 12, 1983
- Revision received October 17, 1983
- Accepted October 28, 1983
- Published online April 1, 1984.
- Moysey Povzhitkov, MD, PhD, FACC,
- Roberto V. Haendchen, MD,
- Samuel Meerbaum, PhD, FACCa,
- Michael C. Fishbein, MD, FACC,
- William Shell, MD, FACC and
- Eliot Corday, MD, FACC
- ↵aAddress for reprints: Samuel Meerbaum, PhD, Cedars Sinai Medical Center, Halper Research Building, 8700 Beverly Boulevard, Los Angeles, California 90048.
Prostaglandin E1was administered by means of coronary venous synchronized retroperfusion and the effectiveness of the combined (prostaglandin-retroperfusion) system was examined during acute myocardial Ischemia in 10 closed chest anesthetized dogs. Such treatment was administered between 30 minutes and 3 hours after occlusion of the proximal left anterior descending coronary artery. An equivalent series of 10 dogs with arterial blood retroperfusion alone and 9 untreated dogs served as control subjects. Standardized two-dimensional echocardiographic measurements of global and regional left ventricular function were performed in five short-axis cross sections. The global low left ventricular section and its profoundly ischemic anterolateral region exhibited distinctly improved systolic fractional area changes as a result of the prostaglandin E1retroperfusion treatment between 30 minutes and 3 hours after occlusion (22.9 ± 1.5to41.2 ± 4.0% and 1.8 ± 3.6 to 29.4 ± 5.6%, respectively). In contrast, further deterioration in function was noted during an untreated equivalent coronary occlusion period (16.3 ± 2.7 to 10.0 ± 3.3% and 12.6 ± 6.1 to 4.1 ± 6.9%). Although arterial blood retroperfusion alone provided distinct benefits in the ischemic region of a midpapillary echo section (from 13.4 ± 3.9 to 32.1 ± 10.4%, p < 0.05), no improvements were observed in profoundly jeopardized segments at the low left ventricular level (5.6 ± 6.0 to 0.9 ± 5.7%).
Triphenyltetrazolium chloride delineation of infarction revealed significant myocardial salvage with prostaglandin E, retroperfusion as compared with findings in untreated control dogs (3.7% ± 1.3% of the left ventricle versus 9.3 ± 1.9%, p < 0.05). The respective ratios of necrosis to glycogen-depleted ischemic zones in a mid-left ventricular slab were 19.5 ± 6.4% versus 47.1 ± 8.9 (p < 0.05).
It is concluded that retrograde prostaglandin E, administration may further enhance the effectiveness of synchronized coronary venous retroperfusion treatment of jeopardized acutely ischemic myocardium.
This study was supported in part by Grants HL 17651-08, HL 14644-08 and HL 14644-09 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MarylandThis study was supported in part by Grants HL 17651-08, HL 14644-08 and HL 14644-09 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; the Ahmanson Foundation; the W.M. Keck Foundation; Mr. and Mrs. E.E. Fogelson, Mr. Morris Blank, Mr. and Mrs. Harry Roman, Mr. J. C. Dunas, Mr. and Mrs. Abe Lipsey, Mrs. Florence Hamilton and Mrs. Rita Schreiber, Los Angeles, California
- Received April 12, 1983.
- Revision received October 17, 1983.
- Accepted October 28, 1983.
- American College of Cardiology Foundation