Author + information
- Received July 17, 1984
- Revision received September 14, 1984
- Accepted October 15, 1984
- Published online March 1, 1985.
- Shigeru Yamazaki, MD1,
- J. Kevin Drury, MD, FACC1,
- Samuel Meerbaum, PhD, FACC1 and
- Eliot Corday, MD, FACC*,1
- ↵*Address for reprints: Eliot Corday, MD, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Halper 325, Los Angeles, California 90048.
The effect of synchronized coronary venous retroper-fusion of arterial blood on cardiac function after experimental coronary occlusion was examined by two-dimensional echocardiography. In 18 closed chest anesthetized dogs, the proximal left anterior descending coronary artery was occluded for 6 hours with an intracoronary balloon catheter. Eight of these animals served as untreated controls. Ten were treated with synchronized retroperfusion initiated 30 minutes after occlusion, and treatment was interrupted for 5 minutes at 1 hour after occlusion for study of the rapidity of retroperfusion response. Quantitative echographic analysis yielded global ejection fraction and regional indexes of contraction in a low left ventricular short-axis section, including segmental systolic area change, systolic wall thickening and end-diastolic wall thickness.
At 6 hours after occlusion, ejection fraction had decreased from 50.7 ± 4.9% to 28.1 ± 7.7% (mean ± standard deviation) in control dogs, but was significantly (p < 0.01) less depressed in treated dogs (from 55.9 ± 5.2 to 41.8 ± 9.3%). The ischemic zone fractional area change at 30 minutes of occlusion exhibited a marked depression in both groups, after which the dysfunction persisted in the control dogs, but was largely reversed with retroperfusion from 6.0 ± 6.5 to 35.9 ± 15.9% at 6 hours of occlusion (p < 0.01). Brief interruption of retroperfusion 1 hour after occlusion reduced ischemic zone fractional area change from 33.0 ± 14.9 to 12.2 ± 9.5% (p < 0.01). This depression was promptly reversed to 33.6 ± 12.2% when retroperfusion was resumed. Segmental wall thickening followed a similar trend.
Compared with previously observed derangements of sudden reperfusion, retroperfusion did not result in increased diastolic wall thickness in the ischemic zone and was not associated with arrhythmias. Thus, synchronized retroperfusion rapidly restored regional as well as global cardiac function during acute coronary occlusion.
- Received July 17, 1984.
- Revision received September 14, 1984.
- Accepted October 15, 1984.
- American College of Cardiology Foundation