Author + information
- Received October 25, 1983
- Revision received December 19, 1983
- Accepted December 21, 1983
- Published online June 1, 1984.
- Roberto V. Haendchen, MD*,
- Eliot Corday, MD, FACCa,
- Marco Torres, MD,
- Gerald Maurer, MD, FACC,
- Michael C. Fishbein, MD, FACC and
- Samuel Meerbaum, PhD, FACC
- ↵aAddress for reprints: Eliot Corday, MD, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Halper 3, Los Angeles, California 90048.
Two-dimensional echocardiographic measurements of regional left ventricular end-diastolic wall thickness and systolic wall thickening were studied during coronary artery occlusion and early after reperfusion and compared with measurements of regional myocardial infarct size. In 25 closed chest anesthetized dogs with left anterior descending coronary artery occlusion followed by reperfusion, the occlusion period was 3 minutes in group I (n = 4), 20 minutes in group II (n = 4), 60 minutes in group III (n = 5) and 180 minutes in group IV (n = 12). Infarct size in groups III and IV was quantitated using the triphenyltetrazolium chloride technique.
After coronary occlusion, wall thickening was replaced by thinning in the center of the ischemic region at the midpapillary echographic short-axis section, and no improvement in function occurred up to 60 minutes after reperfusion, except in group I. Ischemic zone enddiastolic wall thickness did not change significantly from control to the end of the coronary occlusion period, except Group IV. At 60 minutes after reperfusion, enddiastolic wall thickness increased only slightly in groups I and II (by 7.2 and 0.24%, respectively), but a marked increase was observed in groups III and IV (by 41 and 50%, respectively). The percent change in ischemic zone end-diastolic wall thickness from before reperfusion to 60 minutes after reperfusion correlated well with the amount of myocardial necrosis in corresponding segments (r = 0.936, standard error of estimate = 11.4%); an increase in segmental end-diastolic wall thickness of more than 25% was generally associated with 20% or more segmental necrosis.
It is concluded that significantly increased regional end-diastolic wall thickness early after reperfusion is associated with irreversibly damaged myocardium, and this might be used as an index of myocardial salvage.
↵* Present address: Instituto de Cardiologia Dante Pazzanese, CP 215, Sao Paulo, SP 01420, Brazil.
This study was presented in part at the American College of Cardiology Annual Meeting, March 1983, New Orleans, Louisiana. It was supported in part by Grants HL 17561-08 and HL 14644-09 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, The Medallion Group of Cedars-Sinai Medical Center and the WM. Keck Foundation, Los Angeles, California.
- Received October 25, 1983.
- Revision received December 19, 1983.
- Accepted December 21, 1983.
- American College of Cardiology Foundation