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PubMed1991

Effect of aprotinin to improve myocardial viability in myocardial preservation followed by reperfusion.

Isolated canine hearts were preserved at 4 degrees C with multi-dose cardioplegic solution every hour for 6 hours. Reperfusion was observed for 2 hours under cross-circulation without cardiotonic drugs. The aprotinin group (n = 8), which received cardioplegic solution with added aprotinin (150 KIU/mL), was compared with the control group (n = 6). The increase in tissue adenosine triphosphate and total adenine nucleotide content during reperfusion was significant in the aprotinin group; there was no change in the control group, and the levels at the end of reperfusion tended to be higher in the aprotinin group than in the control group. Tissue adenosine diphosphate levels remained unchanged in both groups. Tissue adenosine monophosphate levels declined during reperfusion in both groups and were slightly lower in the control group. Tissue levels of cyclic adenosine monophosphate remained unchanged in the aprotinin group whereas they increased during ischemia and declined significantly during reperfusion in the control group. Tissue levels of cyclic guanosine monophosphate declined during reperfusion in both groups without difference. Creatine phosphate levels recovered in both groups without difference. Serum cyclic guanosine monophosphate concentration tended to be lower in the aprotinin group than in the control group. Serum creatine kinase-MB level increased slightly during reperfusion in both groups without difference. N-acetyl-beta-D-glucosaminidase levels were significantly suppressed during reperfusion in the aprotinin group as compared with the control group. These results suggest that aprotinin is effective in preserving adenine nucleotide and adenosine triphosphate levels and in stabilizing tissue cyclic adenosine monophosphate levels in prolonged hypothermic cardioplegic preservation followed by reperfusion.

Acetylglucosaminidase↗
PubMed1990

Evidence for a sodium-dependent sugar transport in rat tracheal epithelium.

The presence of Na(+)-coupled sugar transport in rat trachea was investigated using the nonmetabolizable glucose analogs methyl alpha-glucopyranoside and 3-O-methylglucose. The rates of disappearance from tracheal instillates and the tissue uptake of these analogs were compared with those of L-glucose. Experiments were performed in vivo, using a cross-circulation preparation, and in vitro, on tracheal strips. The analog methyl alpha-glucopyranoside was removed in vivo from the tracheal lumen faster than L-glucose. The cellular uptake in vivo or in vitro was determined by lysing the cells lining the tracheal lumen with detergents. This uptake was inhibited by luminal glucose, phloridzin and Na+ substitution with choline. The transport rate of 3-O-methylglucose was very low and thus discouraged inhibition experiments. These results indicate the presence of a Na+/sugar cotransport system in rat trachea. The effects of luminal interactions suggest that the cotransport is located in the apical membrane of the tracheal epithelium. It resembles that previously described in the rat alveolar epithelium, but apparently differs from that found in the fetal sheep lung in which a significant 3-O-methylglucose cotransport with Na+ has been described.

3-O-Methylglucose↗
PubMed1990

A minimally invasive technique for multiple measurement of regional blood flow of the rat brain using radiolabeled microspheres.

To observe the rat brain blood flow with microspheres, a left ventricular catheter for sphere introduction was threaded into position via the right brachial artery. Cross-circulation with a donor rat was employed to prevent any mismatch between the infused and sampled blood volumes. Multiple measurements yielded stable flow data, and the responsiveness to hypercapnia was well preserved, irrespective of the dose of injected spheres (48 x 10(3) and 130 x 10(3)).

Animals↗
PubMed1976

Modification by manganese ions and verapamil of the responses of the atrioventricular node to norepinephrine.

In isolated and cross-circulated canine A-V node preparations single injections of Mn2+ (1-30 mumol) and verapamil (0.3-10 nmol) into the posterior septal artery (PSA) caused a dose-dependent increase in the A-V conduction time and, in large doses, produced A-V conduction block. The A-V conduction time increased by Mn2+ and verapamil is resotred by 1-norepinephrine (1-NE) injected into the PSA. The A-V nodal tachycardia induced by 1-NE is suppressed by Mn2+ but not by verapamil. These indicate the following: (1) the slow Ca2+ channel plays an important role in A-V conduction; (2) the positive dromotropic response of the A-V node to 1-NE may have some relations to the Ca2+ channel; (3) the A-V nodal tachycardia induced by 1-NE may be mediated by the Ca2+ channel. Possible causes which produced differences between Mn2+ and verapamil in the effects in antagonizing the 1-NE-induced A-V nodal tachycardia are discussed.

Animals↗
PubMed1979

Analysis of the contractile responses of the ileal segment of the isolated blood-perfused small intestine of rats to adenosine triphosphate and related compounds.

For close-arterial injection the isolated small intestine of the rat was perfused by a cross-circulation technique at a fixed flow rate through the superior mesenteric artery with arterial blood from a donor. Single intra-arterial injections of purine derivatives elicited a monophasic fast contraction of the ileum. In order to elucidate the mechanism of the fast contraction, adenosine triphosphate (ATP) was chosen for further investigations. The ileal response to ATP was abolished by tetrodotoxin, hexamethonium or morphine, but was resistant to blockade by atropine, methysergide or mepyramine. These results definitely indicate that ATP causes the fast contraction of the ileum by a stimulation of neuronal elements in the myenteric plexus involving cholinergic interneurons.

Adenine Nucleotides↗
PubMed1993

Involvement of ATP-sensitive K+ channels in the sustained coronary vasodilator response to adenosine in dogs.

Coronary vasodilator mechanisms of adenosine were investigated in isolated canine papillary muscle preparations cross-circulated through the anterior septal artery with support dogs. Infusions of adenosine (1-3000 nmol/min) for 3 min into this artery caused a transient increase (the initial phase) in blood flow followed by a sustained increase (the sustained phase), and single-bolus intra-arterial injections of adenosine (0.3-1000 nmol) produced only a transient increase in blood flow. The force of contraction of the papillary muscle was virtually unaffected. The increase in blood flow in the sustained phase was antagonized by glibenclamide (6 mumol/kg i.v.), a blocker of ATP-sensitive K+ channels, administered to support dogs whereas increases in both phases were antagonized by 8-phenyltheophylline (12 mumol/kg i.v.), a non-selective adenosine receptor antagonist, administered in a similar way. The transient increase in blood flow caused by single-bolus injections of adenosine was reduced in duration rather than in peak value by glibenclamide. Thus, it appears that opening of ATP-sensitive K+ channels gradually becomes involved in the vasodilator mechanisms for adenosine A2 receptor-mediated, sustained vasodilation.

Adenosine↗
PubMed1984

The effects of body immersion on aqueous humor dynamics in rabbits.

Rabbits subjected to free-floating body immersion demonstrated decreases in intraocular pressure followed by later increases. These intraocular pressure alterations were associated with parallel changes in aqueous humor production. Episcleral venous pressure was elevated during immersion but outflow facility was unaltered. The decrease in intraocular pressure could be partially blocked by pretreatment with vasopressin or desoxycorticosterone acetate. In cross-circulation studies between an immersed and non-immersed rabbit, a decrease in intraocular pressure was observed in both animals. This observation further supported the involvement of humoral factors in the body-immersion induced intraocular pressure response.

Animals↗
PubMed1983

Dysfunction of supramedullary alpha-adrenergic mechanisms following sino-aortic denervation in Kyoto Wistar rats.

Central alpha-adrenergic mechanisms of blood pressure regulation were investigated by injecting norepinephrine or bradykinin into the carotid input of the cross-circulated head preparations of normotensive Wistar Kyoto rats (WKY). Rats were divided into three groups: sham-operated (sham), carotid sinuses denervated (SD) and carotid sinuses and aortic nerves debuffered (SAD). Norepinephrine, 5 micrograms, produced vasodepression in all rats, accompanied by corresponding decreases in sympathetic nerve activity recorded in some rats. Magnitude of vasodepression was largest in SAD rats. In sham rats, bradykinin, 1 micrograms, produced a biphasic response: initial vasodepression followed by a sustained pressor phase. This was accompanied by corresponding changes in peripheral sympathetic nerve activity recorded in some rats. In both SAD and SD rats bradykinin-induced vasodepression was abolished, while the magnitude of the pressor phase became more prominent. The increase in the pressor phase was greater in SAD than in SD rats. In similar studies of spontaneously hypertensive rats (SHR), responses to both alpha-adrenergic agonist and bradykinin are augmented, suggesting a dysfunction of hypothalamic alpha-adrenergic mechanisms. Since in the present study it has been shown that sino-aortic denervation produces effects similar to those seen in SHR, dysfunction of buffer nerves may account for the deficient central alpha-adrenergic mechanisms in SHR.

Animals↗
PubMed1992

Sympathetic and metabolic mechanisms of the cerebrovasomotor function of the caudal ventrolateral medulla in rats.

We attempted to elucidate the cerebrovasomotor function of the caudal ventrolateral medulla. Sixty-one rats were anaesthetized, paralysed and artificially ventilated. The microsphere method was employed for the measurement of blood flow. Microinjection of an antagonist of excitatory amino acids, kynurenate (2 nmol), into functionally identified depressor sites within the caudal ventrolateral medulla produced arterial hypertension of about 140 mmHg. We found that the cerebral blood flow was substantially increased, but was maintained at the same level (17 rats) as that observed under phenylephrine-induced hypertension (26 rats). Bilateral severing of the cervical sympathetic trunks resulted in a further increase in blood flow in all brain regions studied (18 rats). The response was most significant in the cerebral parasagittal cortex (164 +/- 31% of baseline without, and 211 +/- 43% with sympathectomy; mean +/- S.D.; P < 0.001). The contributions of the cerebral metabolic mechanism to this flow increase under denervation was minimal, as evidenced by the observation of disproportionately smaller changes in cerebral metabolic rate for oxygen during any type of hypertension. We conclude that the cerebrovasomotor functions of the caudal ventrolateral medulla may operate to keep an equilibrium between simultaneously working tonic inhibitions against sympathetic vasoconstriction as well as against vasodilatation. This dual effect is mediated by excitatory amino acid receptors located within this particular brain area. The vasodilator mechanism may be of neurogenic origin. When the function of the brain area is suppressed, the subsequently disinhibited vasodilator mechanism dominates the cerebrovascular autoregulatory function.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Effects of methoxamine and phenylephrine on left ventricular contractility in rabbits.

The end-systolic pressure-volume relation is employed to evaluate left ventricular contractility. In clinical studies, pharmacologic vasoconstriction is used to increase left ventricular systolic pressure to assess pressure-volume relations. However, the effect of vasoconstrictors on the ventricular contractile state is not well characterized. The effects of methoxamine and phenylephrine on systemic arterial pressure and left ventricular contractility in rabbits were studied with three protocols. In protocol 1, anesthetized rabbits (n = 10) were injected with incremental doses of methoxamine and phenylephrine intravenously. Methoxamine (4 mg) increased the mean arterial pressure by 50 +/- 12% (mean +/- SE) (n = 5, p = 0.001). Phenylephrine (0.2 mg) increased mean arterial pressure by 82 +/- 14% (n = 5, p = 0.004). In protocol 2, isolated blood-perfused hearts were injected with incremental doses of these drugs in the ascending aorta in amounts approximately equal to the concentrations injected in the intact rabbits. Methoxamine (2 mg) reduced isovolumic peak systolic left ventricular pressure by 43 +/- 9% (n = 7, p = 0.003), whereas phenylephrine (0.1 mg) increased the isovolumic pressure by 24 +/- 9% (n = 7, p less than 0.05). These responses indicated an enhanced contractile state with phenylephrine and a reduced contractile state with methoxamine. Pretreatment with propranolol blunted the effect of phenylephrine on isovolumic pressure (n = 6, p less than 0.02). In protocol 3, cross-circulation experiments allowed study of the effect of these drugs on isovolumic left ventricular pressure in the isolated heart and simultaneously on the systemic arterial pressure in the intact anesthetized rabbit (support rabbit).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Conjoined omphalopagous twins separated at fifteen days of age].

BACKGROUND: Conjoined (siamese) twins represent a rare situation which may occur in 1 of every 50,000 births. A prenatal diagnosis usually leads to stopping pregnancy. We report a case with successful surgical separation at the age of 15 days. CASE REPORT: Ultrasonographic examination at 20 weeks of gestation showed omphalopagus siamese joined at the abdomen from the xiphoid process to the umbilicus. Conjoined structures included liver. There was a multicystic right kidney in one twin, without other malformation. Karyotype was normal, 46XX. The mother refused interruption of her pregnancy. Both girls were born by cesarean section. Angiography, magnetic resonance imaging and intravenous urography confirmed the ultrasound examination. There was no cross circulation into the liver and the gastrointestinal tract was not conjoined. The twins were separated at 15 days of age with right heminephrectomy of the multicystic kidney. The girls are now 16 months old and are in very good health. CONCLUSION: Prognosis of siamese twins depends on the nature of joined structures and presence of malformations. Ultrasonographic examination during pregnancy shows the possibility of surgical separation, which is performed by a double anesthetic and surgical pediatric team. Preoperative investigations must include MRI.

Female↗
PubMed2006

Celsior preserved cardiac mechanoenergetics better than popular solutions in canine hearts.

BACKGROUND: Better protective effects of Celsior on cardiac function than the other conventional solutions have been reported in acute experiments and in clinical trials for at-risk patients. However, no study has yet precisely elucidated how these preservation solutions affect cardiac mechanoenergetics. Therefore, we evaluated the effects of St. Thomas' Hospital solution No. 2, University of Wisconsin solution, and Celsior on left ventricular contractility (Emax: end-systolic pressure-volume ratio) and oxygen consumption. METHODS: We used 32 canine excised cross-circulated hearts. Twenty-three hearts served as donor hearts after hypothermic ischemia with one of the three solutions, and the remaining 9 served as controls. After arrest with each solution, the hearts were preserved for 4 hours at 4 degrees C. Then, we measured left ventricular pressure, volume, and oxygen consumption to obtain Emax and the relation between ventricular pressure-volume area (a measure of total mechanical energy) and oxygen consumption. We also evaluated the oxygen cost of Emax by changing Emax with calcium administration. RESULTS: Celsior did not significantly affect E(max) (6.3 +/- 2.4 in control versus 5.3 +/- 1.3 mm Hg.mL(-1).100 g with Celsior) nor the oxygen cost of Emax (1.2 +/- 0.6 versus 1.6 +/- 0.5 mL O2.mL.mm Hg(-1).beat(-1).100 g(-2), respectively). In contrast, St. Thomas' Hospital and University of Wisconsin solutions significantly decreased Emax (4.5 +/- 1.1 and 3.5 +/- 0.9 mm Hg.mL(-1).100 g, respectively) and increased the oxygen cost of Emax (2.5 +/- 0.8 and 2.4 +/- 0.9 mL O2.mL.mm Hg(-1).beat(-1).100 g(-2), respectively) compared with control and Celsior-preserved hearts. The slope and intercept of the oxygen consumption versus pressure-volume area relation showed no significant difference among the four groups. CONCLUSIONS: Celsior showed better protective effects on cardiac mechanoenergetics than St. Thomas' Hospital and University of Wisconsin solutions in the acute phase of heart transplantation.

Animals↗
PubMed2005

Absence of PERV infection in baboons after transgenic porcine liver perfusion.

BACKGROUND: Xenotransplantation offers great promise to supplement the shortage of human organs available for transplant, but cross-species infection is a substantial concern. Porcine endogenous retrovirus (PERV), in particular, is thought to pose a risk as a potential pathogen to humans. We evaluated whether PERV is capable of infecting nonhuman primates in vivo after extracorporeal porcine liver perfusion (ECLP). METHODS: Livers were harvested from six human decay-accelerating factor (h-DAF) transgenic piglets and perfused with fresh baboon blood via the portal vein and the hepatic artery. Six healthy baboons underwent direct cross-circulation with the ECLP for 13 to 24 h without immunosuppression. Peripheral blood and bone marrow of baboons were sampled periodically until the baboons were euthanized for the examination of various organ tissue samples. Genomic DNA was extracted from those samples and tested for PERV and pig-specific centromeric DNA sequences by quantitative PCR. Validation showed that the assay could detect one copy of PERV in a background of 150,000 baboon cells, and it was quantitative over a range from 10 to 10(6) copies of PERV. RESULTS: PERV sequences were detected in a high number (4.4 x 10(3)-1.6 x 10(4)/1 microg) in peripheral leukocyte DNA during the initial phases of ECLP, but they disappeared within 1 week. Bone marrow DNA contained PERV sequences longer than peripheral blood, but PERV signals became negative within 1 month. No PERV DNA relapse was seen over the course of this study. Pig-specific centromeric sequences were also detected in the same manner. At 6 months or 1 year after ECLP, no PERV or pig-specific centromeric sequences were detected in the genomic DNA obtained from the following organs: skin, lymph nodes, spleen, liver, pancreas, kidney, heart, and lung. CONCLUSIONS: ECLP did not result in PERV infection or pig-cell microchimerism in baboons.

Animals↗
PubMed2006

Mechanical and metabolic rescue in a type II diabetes model of cardiomyopathy by targeted gene transfer.

The Otsuka-Long-Evans Tokushima Fatty rat represents a model for spontaneous non-insulin-dependent type II diabetes mellitus (DM), characterized by diastolic dysfunction and associated with abnormal calcium handling and decrease in sarcoplasmic reticulum Ca2+ -ATPase (SERCA2a) expression. The aim of this study was to examine whether SERCA2a gene transfer can restore the energetic deficiency and left ventricular (LV) function in this model. DM rats were randomized to receive adenovirus carrying either the SERCA2a gene (DM + Ad.SERCA2a) or the beta-galactosidase gene (DM + Ad.betaGal) or saline (DM + saline). LV mechanoenergetic function was measured in cross-circulated heart preparations 3 days after infection. In DM, end-systolic pressure at 0.1 ml intraballoon water (ESP0.1) was low and end-diastolic pressure at 0.1 ml intraballoon water (EDP0.1) was high (22 mm Hg), compared with non-DM (EDP0.1 12 mm Hg). In DM + Ad.SERCA2a, however, ESP0.1 was increased over 200 mm Hg and EDP(0.1) was decreased to 7 mm Hg. LV relaxation rate was fast in DM + Ad.SERCA2a, but slow in the other DM groups. There was no difference in relation between cardiac oxygen consumption per beat and systolic pressure-volume area among all groups. Finally, the oxygen cost of LV contractility in DM was about three times as high as that of normal. In DM + Ad.SERCA2a, the oxygen cost decreased to control levels, but in DM + Ad.betaGal/DM + saline it remained high. In DM failing hearts, the high oxygen cost indicates energy wasting, which contributes to the contractile dysfunction observed in diabetic cardiomyopathy. SERCA2a gene transfer transforms this inefficient energy utilization into a more efficient state and restores systolic and diastolic function to normal.

Adenoviridae↗
PubMed1993

Evolution of the bioartificial liver: the need for randomized clinical trials.

The pursuit of a bioartificial liver is well documented in the literature. Early techniques of artificial liver support that have undergone clinical testing included simple exchange transfusions, extracorporeal xenogeneic or allogeneic liver perfusion, cross-circulation, hemodialysis, charcoal hemoperfusion, and plasmapheresis with plasma exchange. These techniques failed because they were unable to adequately support those hepatic functions essential for survival and because they lacked a back-up therapy, such as liver transplantation, for irreversible forms of liver disease. The concept evolved that hepatic functions essential for survival would be best performed by hepatocytes in an apparatus that allowed sustained or repetitive application. The best results have been achieved with bioartificial liver technologies that employ hepatocytes as implantable systems or extracorporeal devices. Implantable bioartificial liver systems include hepatocytes that have been on coated microcarrier beads, within microencapsulated gel droplets, within biodegradable polymeric substrates, or as spheroid hepatocyte aggregates. Extracorporeal systems include hepatocytes in suspension, on flat plates, and in hollow fiber bioreactors. Several extracorporeal systems have undergone extensive animal testing and are entering the early stages of human clinical trials. Randomized trials are needed to establish the value of bioartificial liver support in the treatment of patients with acute hepatic failure or as a bridge to liver transplantation.

Animals↗
PubMed2000

Platelet activating factor acetylhydrolase decreases lung reperfusion injury.

BACKGROUND: Ischemia-reperfusion injury involves free radical production, polymorphonuclear neutrophil chemotaxis/degranulation, and production of proteolytic enzymes, complement components, coagulation factors, and cytokines. Activated polymorphonuclear neutrophils, endothelial cells, and macrophages produce platelet activating factor, which further promotes these inflammatory reactions. The recently cloned plasma form of platelet activating factor-acetylhydrolase (PAF-AH) demonstrates antiinflammatory effects by degrading platelet activating factor. We evaluated the effects of PAF-AH in an isolated perfused rat lung model by adding it to the flush solutions or to the reperfusion blood. METHODS: Rat lungs were isolated, flushed with EuroCollins (EC) or University of Wisconsin (UW) solution, stored at 4 degrees C for 6 or 12 hours, and reperfused using a cross-circulating syngeneic support rat. During reperfusion, oxygenation, compliance, and capillary filtration coefficient were calculated. There were four groups in the study; group I (control) had no PAF-AH added, group II had PAF-AH added to the flush solution, group III had PAF-AH added to reperfusion blood, and group IV had PAF-AH added to both flush solution and reperfusion blood. RESULTS: After 6 hours of storage, oxygenation, compliance, and capillary filtration coefficient significantly improved for EC in group IV. For UW, oxygenation improved in group IV whereas compliance improved in groups II, III, and IV. After 12 hours of storage, compliance improved for EC in group IV and capillary filtration coefficient improved in groups III and IV. For UW, oxygenation and compliance improved in groups II and IV, whereas capillary filtration coefficient improved in group IV. CONCLUSIONS: Addition of PAF-AH to intracellular organ preservation solutions and to the blood reperfusate significantly improves postreperfusion oxygenation and compliance, and reduces lung capillary permeability.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1998

Effect of pressure on myocardial function after 6-hour preservation with blood cardioplegia.

BACKGROUND: This study examined the return of cardiac function in pig hearts after 6 hours' preservation by continuous perfusion with blood cardioplegia at two perfusion pressures compared with preservation with crystalloid solutions. METHODS: Isolated pig hearts were randomly divided into five groups (n = 8 per group) according to the following treatments: group 1 = fresh hearts (control); group 2 = hearts arrested with Queen's cocktail cardioplegia and then immersion in 0 degrees C saline solution (QS group); group 3 = hearts arrested with (5 degrees C) and simple immersion in 0 degrees C University of Wisconsin solution (UW group); and groups 4 and 5 = hearts arrested with blood cardioplegia at 10 degrees C and then continuously perfused at a pressure of 80 cm H2O or 40 cm H2O, respectively (groups BC80 and BC40). After preservation for 6 hours, donor hearts were reperfused by a cross-circulation support pig. Thereafter, cardiac function and metabolism were examined every half hour for 2 hours. A three-way mixed general linear model was used to analyze data with repeated measures. Bonferroni test was used to determine differences (p < or = 0.05) between groups. RESULTS: Only 4 hearts recovered electric activity in the BC80 group (p < or = 0.05 versus other groups). There was poor recovery of left ventricular work in the BC80 group compared with the other groups (p < 0.001). Left ventricular work in the QS and UW groups was also lower than in the control and BC40 groups. Left ventricular work in the BC40 group fully recovered. Maximum elastance did not differ between groups. Compliance was reduced in the QS, BC80, and BC40 groups versus controls after preservation (p < 0.006). Coronary flow decreased and coronary vascular resistance increased in the BC80 group versus the other groups (p < or = 0.001). Coronary flow in the QS, UW, and BC40 groups was lower than in the control group (p < 0.001). The magnitude of lactate release was much higher in the BC80 group than in the other groups (p < or = 0.001). CONCLUSIONS: Continuous perfusion with 10 degrees C blood cardioplegia at 40 cm H2O pressure for 6 hours provided adequate preservation of systolic function in this model. University of Wisconsin solution provided the best protection of diastolic function.

Adenosine↗
PubMed1997

Dynamic cardiac compression improves contractile efficiency of the heart.

The effect of dynamic cardiac compression on left ventricular contractile efficiency was assessed in terms of the pressure-volume relationship and myocardial oxygen consumption. In 11 excised cross-circulated dog hearts, the ventricle was directly compressed during systole (dynamic cardiac compression). Measurements for pressure-volume area (a measure of total mechanical energy), external work, and myocardial oxygen consumption were done before and during dynamic cardiac compression. Dynamic cardiac compression increased pressure-volume area by 28% +/- 17% (mean plus or minus the standard deviation) and external work by 24% +/- 20% (p = 0.0000185 and 0.0000212, respectively) at given end-diastolic and stroke volumes without affecting myocardial oxygen consumption. As a result, the oxygen cost of pressure-volume area, that is, the slope of the myocardial oxygen consumption-pressure-volume area relationship, significantly decreased by 16% +/- 13% (p = 0.0000135) whereas the pressure-volume area-independent myocardial oxygen consumption was unchanged. Then, contractile efficiency, that is, the reciprocal of the slope of the myocardial oxygen consumption-pressure-volume area relationship in joules significantly improved from 45% +/- 8% to 53% +/- 13% (p = 0.0000437). When the native myocardial oxygen consumption-pressure-volume area relationship was assessed by subtracting the dynamic cardiac compression pressure applied to the heart, the slope of the myocardial oxygen comsumption-pressure-volume area relationship returned to the control level. This indicates that the contractile efficiency of the native heart was not affected by dynamic cardiac compression. We conclude that dynamic cardiac compression enhances left ventricular pump function by improving the contractile efficiency of the overall heart leaving the energetics of the native heart unchanged.

Animals↗