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PubMed2005

Accuracy and feasibility of dynamic contrast-enhanced 3D MR imaging in the assessment of lung perfusion: comparison with Tc-99 MAA perfusion scintigraphy.

AIM: The aim of this study was to correlate findings of perfusion magnetic resonance imaging (MRI) and perfusion scintigraphy in cases where there was a suspicion of abnormal pulmonary vasculature, and to evaluate the usefulness of MRI in the detection of perfusion deficits of the lung. METHODS: In all, 17 patients with suspected abnormality of the pulmonary vasculature underwent dynamic contrast-enhanced MRI. T1-weighted 3D fast-field echo pulse sequences were obtained (TR/TE 3.3/1.58 ms; flip angle 30 degrees; slice thickness 12 to 15 mm). The dynamic study was acquired in the coronal plane following administration of 0.1 mmol/kg gadopentetate dimeglumine. A total of 8 to 10 sections repeated 20 to 25 times at intervals of 1s were performed. Perfusion lung scintigraphy was carried out a maximum of 48 h before the MR examination in all cases. Two radiologists, who were blinded to the clinical data and results of other imaging methods, reviewed all coronal sections. MR perfusion images were independently assessed in terms of segmental or lobar perfusion defects in the 85 lobes of the 17 individuals, and the findings were compared with the results of scintigraphy. RESULTS: Of the 17 patients, 8 were found to have pulmonary emboli, 2 chronic obstructive pulmonary disease with emphysema, 2 bullous emphysema, 2 Takayasu arteritis and 1 had a hypoplastic pulmonary artery. Pulmonary perfusion was completely normal in 2 cases. In 35 lobes, perfusion defects were detected using both methods, in 4 with MR alone and in 9 only with scintigraphy. There was good agreement between MRI and scintigraphy findings (kappa=0.695). CONCLUSION: Pulmonary perfusion MRI is a new alternative to scintigraphy in the evaluation of pulmonary perfusion for various lung disorders. In addition, this technique allows measurement and quantification of pulmonary perfusion abnormalities.

Adult↗
PubMedDate not supplied

Hypothermic machine perfusion of the liver and the critical balance between perfusion pressures and endothelial injury.

Hypothermic machine perfusion (HMP) provides better protection against cold ischemic injury than cold storage in marginal donor kidneys. Also, in liver transplantation a switch from static cold storage to HMP could be beneficial as it would allow longer preservation times and the use of marginal donors. A critical question concerning application of HMP in liver preservation is the crucial balance between perfusion pressure and occurrence of endothelial injury. Rat livers were cold-perfused for 24 hours to study perfusion pressures for both hepatic artery and portal vein. Cold storage served as control and was compared to HMP-preserved livers using a mean arterial perfusion pressure of 25 mm Hg and a portal perfusion pressure of 4 mm Hg (25% of normothermic liver circulation) and to HMP at 50 mm Hg and 8 mm Hg perfusion, respectively (50% of normothermic liver circulation). UW solution was enriched with 14.9 micromol/L propidium iodide (PI) to stain for dead cells and with an additional 13.5 micromol/L acridine orange to stain for viable hepatocytes. A low PI-positive cell count was found using HMP at 25% of normal circulation compared to cold storage. The PI count was high for the HMP group perfused at just 50% of normal circulation compared to HMP at 25% and compared to cold storage. In summary, for liver HMP, perfusion at 25% showed complete perfusion with minimal cellular injury. HMP using perfusion pressures of 25 mm Hg for the hepatic artery and 4 mm Hg for the portal vein is feasible without induction of endothelial injury.

Animals↗
PubMed1998

Does simultaneous antegrade/retrograde cardioplegia improve myocardial perfusion in the areas at risk? A magnetic resonance perfusion imaging study in isolated pig hearts.

OBJECTIVE: This study was designed to determine whether simultaneous antegrade/retrograde cardioplegia improves myocardial perfusion in areas supplied by occluded vessels. METHODS: Isolated pig hearts placed in a Langendorff preparation were divided into two groups. The left anterior descending coronary artery was occluded at its origin. In group 1 (n = 7), simultaneous antegrade/retrograde cardioplegia was conducted with use of a single perfusion unit with tubing in a Y-shaped configuration at the end, joined to the aorta and the coronary sinus. In group 2 (n = 8) simultaneous antegrade/retrograde cardioplegia was performed with two separate units, one for antegrade delivery of cardioplegic solution and the other for retrograde cardioplegic solution delivery. Myocardial perfusion in the region supplied by the left anterior descending artery and the region not supplied by this artery was assessed by magnetic resonance imaging, with use of a magnetic resonance contrast agent. The contrast agent was introduced into the common perfusion line in group 1 and into the aortic line only in group 2. RESULTS: Magnetic resonance images showed that the myocardium in the region supported by the left anterior descending artery could not be perfused with antegrade cardioplegic solution because of occlusion of the artery. During simultaneous antegrade/retrograde cardioplegia, however, the myocardium in the left anterior descending region was perfused by approximately 40% to 50% (group 1) or 20% to 30% (group 2) of the degree of perfusion in the region not perfused by the left anterior descending artery (100%). Almost no cardioplegic solution was delivered to the heart through the coronary sinus route during simultaneous antegrade/retrograde cardioplegia in both groups of hearts. Myocardial perfusion in the region supported by the left anterior descending artery was heterogeneous during simultaneous antegrade/retrograde cardioplegia. CONCLUSIONS: Simultaneous antegrade/retrograde cardioplegia significantly improved myocardial perfusion in jeopardized areas of the myocardium. The jeopardized myocardium was mainly perfused by the solution drained from the adjacent normal tissue. Elevated pressure at the coronary sinus during simultaneous antegrade/retrograde cardioplegia is responsible for the redistribution of antegradely delivered cardioplegic solution.

Animals↗
PubMed2002

Follow-up of perfusion defects in pulmonary perfusion scanning after pulmonary embolism: are we too careless?

Persisting perfusion defects may still be found in pulmonary perfusion scintigraphy months or years after pulmonary embolism. The aim of this study was to investigate the rate of persisting perfusion defects and the pattern of scintigraphic follow-up of patients after pulmonary embolism. Only those patients were included into our study who received pulmonary perfusion scintigraphy between 1991 and 1999, and who had perfusion defects including at least one whole segment. These perfusion defects were considered as persisting perfusion defects if unchanged over at least 1 year. From 3640 patients examined, 451 (12.4%) had perfusion defects meeting the criteria of this study. Of those, 129 (28.6%) received a scintigraphic follow-up. In 62 patients (48.1%), a reperfusion of the defects was found. In 38 patients (29.5%), the defects persisted within a follow-up period of up to 12 weeks. However, no pulmonary perfusion scintigraphy was performed thereafter. Out of the 129 patients receiving a scintigraphic follow-up, only 29 (22.5%) had a follow-up over more than 1 year, 19 of those had persisting perfusion defects. It is concluded that our data show an inadequate scintigraphic follow-up of patients with pulmonary embolism which may lead to unnecessary anticoagulant treatment if persisting perfusion defects are misinterpreted as fresh pulmonary embolism. In many cases, there was no further follow-up even if reperfusion of the defects was lacking in early follow-up.

Adult↗
PubMed2006

Microvascular perfusion 1 week and 6 months after myocardial infarction by first-pass perfusion cardiovascular magnetic resonance imaging.

OBJECTIVE: To characterise the evolution of myocardial perfusion during the first 6 months after myocardial infarction by first-pass perfusion cardiovascular magnetic resonance imaging (CMR) and determine its significance. DESIGN: Prospective cohort design. SETTING: Single-centre study in a teaching hospital in Spain. PATIENTS: 40 patients with a first ST-elevation myocardial infarction, single-vessel disease and thrombolysis in myocardial infarction (TIMI) grade 3 flow (stent in 33 patients) underwent rest and low-dose dobutamine CMR 7 (SD 1) and 184 (SD 11) days after infarction. Microvascular perfusion was assessed at rest by visual assessment and quantitative analysis of first-pass perfusion CMR. Of the 640 segments, 290 segments subtended by the infarct-related artery (IRA) were focused on. RESULTS: Both 1 week and 6 months after infarction, segments with normal perfusion showed more wall thickening, contractile reserve and wall thickness, and less transmural necrosis, p <0.05 in all cases. Of 76 hypoperfused segments at the first week, 47 (62%) normalised perfusion at the sixth month. However, 42 segments (14% of the whole group) showed chronic abnormal perfusion; these segments showed worse CMR indices in the late phase (p<0.05 in all cases). CONCLUSIONS: In patients with an open IRA, more than half of the segments with abnormal perfusion at the first week are normally perfused after six months. First-pass perfusion CMR shows that in a small percentage of segments, abnormal perfusion may become a chronic phenomenon-these areas have a more severe deterioration of systolic function, wall thickness, contractile reserve and the transmural extent of necrosis.

Cohort Studies↗
PubMed1995

Hepatic function during prolonged isolated rat liver perfusion using a new miniaturized perfusion circuit.

Previous designs of isolated rat liver perfusion circuits used for toxicological investigations are often expensive, cumbersome, or traumatic in relation to hepatic biocompatibility following extended perfusion times. A new, miniaturized circuit that incorporates a novel design of organ bath, to maintain a buoyant preparation, and a high-efficiency miniaturized membrane tubing oxygenator is described. Livers from male Sprague-Dawley rats were perfused continuously for 6 hr in vitro using rat blood diluted to a perfusate hematocrit of 9.75 +/- 0.35% with Krebs-Henseleit buffer (KHB). Hepatic function was evaluated by measurement of perfusion pressure, flow rate, bile volume production, bile bilirubin content, hepatic oxygen uptake (HOU), bromosulphthalein (BSP) removal, hepatic enzyme activities, and electrolyte concentrations, and finally by histological examination. Perfusion pressure and flow rate remained stable at 8.7 +/- 1.7 mmHg and 1.92 +/- 0.06 mL min-1 g-1 liver, respectively. Bile volume production and HOU were maximal at 784 +/- 84 microL h-1 and 0.99 micromol/L min-1 g-1 respectively. Erythrocyte damage in the perfusate was evaluated by measurement of reduction in perfusate hematocrit from 9.75 +/- 0.35% to 9.27 +/- 0.24%, and increases in plasma free hemoglobin, which rose from 85.8 +/- 12.3 mg% to 650.1 +/- 53.3 mg% over the 6-hr perfusion period studied. Using bile volume production, hepatic oxygen uptake, and the liberation of plasma free hemoglobin as the most sensitive indices of adverse conditions, the new circuit was capable of supporting an isolated perfused rat liver for periods of up to 6 hr under close-to-physiological conditions.

Animals↗
PubMed1984

Six-day canine kidney preservation. Hypothermic perfusion combined with isolated blood perfusion.

Successful 6-day kidney preservation was obtained with a combination of perfusion techniques. Canine kidneys were preserved by hypothermic continuous perfusion in a Gambro machine with albumin perfusate. On day 3 the hypothermic preservation was interrupted by a normothermic perfusion for 3 hr. This intermediate perfusion was performed in a heart-lung machine filled with heparinized blood from non-related dogs. The preserved kidneys were autotransplanted in subsequently nephrectomized dogs. Nine of 11 animals with such preserved kidneys survived in a healthy condition. In the control group with hypothermic perfusion only, one of 8 dogs survived after implantation. In this dog a high serum creatinine concentration was measured after implantation. Kidney function was assessed by determining glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and filtration fraction (FF) during the intermediate blood perfusion in the experimental group and at 1 hr after implantation in both groups. A low FF (less than 0.27) indicated the presence of active functioning tubules in the intermediate blood-perfused group. In this group the GFR, ERPF, and FF values returned to normal within 10 days after implantation. These results show that it is possible to prevent irreversible preservation damage by normothermic blood perfusion. Histological observation indicated that the isolated blood perfusion had a beneficial effect, especially on the tubules of the preserved kidney.

Animals↗
PubMed2006

Effects of vascular perfusion on coagulation size in radiofrequency ablation of ex vivo perfused bovine livers.

OBJECTIVES: A standardized perfused ex vivo bovine liver model was used to evaluate the effect of organ perfusion on coagulation size and energy deposition during radiofrequency ablation (RFA) procedures. MATERIALS AND METHODS: Bovine livers were perfused in a tank after rinsing the prepared liver vessels with anticoagulants. Tyrode's solution, oxygenated and heated to 36.5 degrees C, was used as perfusion medium. A flow and pressure controlled pump regulated Portal vein circulation; a dialysis machine provided pulsatile arterial circulation. Impedance-guided radiofrequency ablations were performed with 4-cm LeVeen electrodes with and without underlying liver perfusion. Two-dimensional diameters (Dv, Dh) of each ablation area were measured after dissecting the livers. RESULTS: In 4 bovine livers weighing 8.85 +/- 0.83 kg per organ (min, 7.7 kg; max, 9.7 kg) altogether 40 RF ablations were performed. A total of 20 ablations were generated with underlying liver perfusion (group 1) and 20 ablations with no liver perfusion (group 2). In group 1, Dv was 28.4 +/- 5.3 mm, Dh 38.6 +/- 7.8 mm, and energy deposition 36.9 +/- 18.0 kJ. The 20 ablation areas generated without liver perfusion displayed statistically significant differences, with Dv being 35.7 +/- 6.5 mm (P = 0.001), Dh 49.5 +/- 9.4 mm (P = 0.001), and energy deposition 25.5 +/- 13.0 kJ (P = 0.018). CONCLUSION: The model reproduced the cooling effect of perfused tissue during RFA. The ablation areas produced under perfusion conditions had smaller diameters despite longer exposure times and higher energy deposition.

Animals↗
PubMed1996

The disposition of morphine and morphine-3-glucuronide in the isolated perfused rat liver: effects of altered perfusate flow rate.

The rat single-pass isolated perfused liver preparation was used to study the effects of altered perfusate flow rate on the hepatic disposition of morphine and its polar metabolite morphine-3-glucuronide (M3G). Using a balanced, cross-over design, livers of female Sprague-Dawley rats (n = 6) were perfused at 15 and 30 mL min-1 with erythrocyte- and protein-free perfusion medium containing a constant concentration of morphine (2.7 microM). After reaching steady-state, inflow and outflow perfusate and bile samples were collected and morphine and M3G were measured by HPLC. Doubling of perfusate flow rate was associated with a significant increase (P < 0.05) in the availability of morphine (mean +/- s.d. of 0.19 +/- 0.06 at 15 mL min-1 and 0.29 +/- 0.08 at 30 mL min-1). The magnitude of the change in morphine availability was consistent with the predictions of the well-stirred model of hepatic elimination. The fate of hepatically generated M3G was assessed by the biliary extraction ratio of M3G; alterations in perfusate flow rate had no significant effect on this ratio (mean +/- s.d. of 0.49 +/- 0.14 at a perfusate flow rate of 15 mL min-1 and 0.47 +/- 0.22 at 30 mL min-1). A physiologically-based mathematical model, in which the vascular and intracellular spaces of the liver were represented by two well-mixed compartments, was utilized to derive an equation for the biliary extraction ratio of M3G. According to the model, the value of this extraction ratio will become insensitive to changes in perfusate flow rate when the permeability for M3G of the membrane separating the intracellular and vascular compartments is low compared with perfusate flow rate. Hence, the experimental results are consistent with the concept that the hepatic sinusoidal membrane represents a diffusional barrier to M3G.

Animals↗
PubMed2006

Effect of pH management on brain perfusion during retrograde cerebral perfusion.

This study was undertaken to determine the effects of different pH management strategies during retrograde cerebral perfusion on the relationship between retrograde perfusion pressure and brain tissue perfusion. Six pigs were subjected to an alpha-stat strategy and another 6 to a pH-stat strategy during hypothermic (15 degrees C) retrograde cerebral perfusion at perfusion pressures of 10 to 70 mm Hg, in increments of 10 mm Hg every 20 min. Regional cerebral blood flow was significantly higher in the pH-stat group than in the alpha-stat group. The cerebral blood flow peaked at perfusion pressures of 40-50 mm Hg (18.6% +/- 10.8% in the pH-stat group vs. 3.6% +/- 1.2% in the alpha-stat group). In both groups, the intracranial pressure remained below the critical level of 25 mm Hg, even at a retrograde perfusion pressure of 70 mm Hg. Cerebral lactate production was higher in the alpha-stat group than the pH-stat group during retrograde cerebral perfusion at pressures of 10-30 mm Hg. Compared to the alpha-stat strategy, the pH-stat strategy significantly improved brain tissue perfusion. With an open inferior vena cava, the optimal perfusion pressure seems to be 40-50 mm Hg.

Animals↗
PubMed1990

Salivary excretion of 5-fluorouracil (5-FU). V. Effect of 5-FU concentration in perfusate on the salivary excretion of 5-FU in perfused rat mandibular gland.

The effect of 5-fluorouracil (5-FU) concentration in the perfusate on the salivary excretion of 5-FU was investigated in the rat mandibular gland perfused with modified Ringer solution containing pilocarpine (10 microM). The saliva to venous-effluent concentration ratio (S/E ratio) of 5-FU increased gradually during the perfusion. The 5-FU concentration in the perfusate ranging from 10 to 200 micrograms/ml caused elevation in the mean value of S/E ratio. This non-linearity suggested that the present perfusion method would be useful to further investigation for the mechanism of salivary excretion of 5-FU, since the tendency of the non-linearity was similar to that in in vivo studies as reported previously. The salivary flow rate declined with time, and the greater mean value of the flow rate was obtained during perfusion with the perfusate containing the lower level of 5-FU. Statistically significant correlation was found between the S/E ratio of 5-FU and salivary flow rate (p less than 0.01). Therefore, in the perfused rat mandibular gland, it was concluded that 5-FU itself had an influence on the salivary excretion of 5-FU via decreasing salivary flow rate. On the other hand, the salivary clearance of 5-FU showed no distinct increase and/or decrease not only with time but also with the change of 5-FU concentration in the perfusate. It seems to result from the cancellation of the increased S/E ratio of 5-FU by the decreased salivary flow rate in perfused rat mandibular gland.

Animals↗
PubMed1990

Beneficial effects of low-flow perfusion resumed early after zero-flow ischemia on myocardial energy metabolism and mechanical function: 31P-NMR study in the isolated perfused rat heart.

Effects of low-flow perfusion after zero-flow ischemia on myocardial mechanical function and energy metabolism were studied with 31P nuclear magnetic resonance spectroscopy, using isolated perfused rat hearts. After control perfusion, hearts were randomly divided into five experimental groups: Groups I and II were subjected to zero-flow ischemia of 40 and 60 min, respectively. In groups III-V the perfusion was resumed at a rate of 0.1 ml/min after 40 (group III), 30 (group IV) and 20 (group V)-min of zero-flow ischemia in order to compare the effects of low-flow perfusion with those of persistent zero-flow. After these interventions all the hearts were perfused for 40 min at a normal flow rate. Compared with the hearts exposed to total ischemia of 60 min, the preservation of high energy phosphate compounds (HEP) was better in groups with early low-flow perfusion; Creatine phosphate (CrP) levels, which had decreased rapidly after induction of zero-flow ischemia, increased gradually after initiation of the low-flow perfusion and reached significantly higher levels at the end of ischemic period in groups IV and V than in group II (p less than 0.05). The decrease in adenosine triphosphate (ATP) was likewise significantly suppressed by low-flow perfusion (groups IV and V greater than group II). Restoration of CrP levels after complete reperfusion was also significantly greater in group V than in group II. The recovery of ATP after complete reperfusion was also much better in group V being comparable to those in group I, although the total duration of ischemia was longer in group V than in group I. These results indicate the beneficial effects of low-flow perfusion on the preservation during ischemia and recovery after reperfusion of myocardial HEP.

Adenosine Triphosphate↗
PubMed1995

Vasoreactivity of Fluosol perfluorocarbon emulsion vs. Earl's balanced salt/albumin perfusates in the isolated perfused rat lung.

We compare the vasoreactive responses of Fluosol perfluorocarbon emulsion versus Earl's balanced salt+albumin solution as perfusates in an isolated perfused rat lung. Comparisons were made with three separate vasoconstrictive stimuli: norepinephrine, and prostaglandin F2 alpha dose-response analysis, and generation of hypoxic pulmonary vasoconstriction. The hypoxia experiments were also performed with N-nitro-arginine added to the perfusates to block production of endogenous nitric oxide prior to the application of hypoxic ventilation challenge. The vasoconstrictive effects of norepinephrine, PGF2 alpha and hypoxia were significantly depressed in the perfluorocarbon perfused versus salt/albumin solution perfused lungs. With the addition of NNA to the perfusates, hypoxic pulmonary vasoconstriction is enhanced in both Earl's/albumin perfused as well as in the fluorocarbon perfused lungs. We can conclude that the pulmonary vasoconstrictive effects of norepinephrine, PGF2 alpha, and hypoxia are depressed in perfluorocarbon emulsion perfused, compared to salt-albumin solution perfused lungs. It is possible that perfluorocarbon emulsions interfere with normal endothelial function. As such, these compounds may be useful in examination of normal and abnormal endothelial function in various research applications.

Albumins↗
PubMed1975

Analysis of the optimal perfusion pressure and flow rate of the renal vascular resistance and oxygen consumption in the hypothermic perfused kidney.

Thirty-six dog kidneys were perfused with different perfusion pressures (between 15 and 60 mm. Hg) for 72 hours and then transplanted. Hypothermic human albumin was the perfusion fluid. Enzyme release, kidney weight, and renal oxygen consumption were measured during perfusion. Kidneys perfused with a flow rate of 0.8 ml. per gram per minute (21 mm. Hg mean perfusion pressure) showed the smallest increase in kidney weight and the best function after transplantation. Renal vascular resistance was independent of the level of the perfusion pressure and renal oxygen consumption was independent of the applied flow rate. It is concluded that the perfusion pressure applied with hypothermic perfusion should be as low as possible because in this way kidney damage caused by perfusion can be avoided most easily.

Animals↗
PubMed2006

Human cancer xenograft perfusion in situ in rats: a new perfusion system that minimizes delivery time and maintains normal tissue physiology and responsiveness to growth-inhibitory agents.

We developed an artificial lung and catheter system for perfusing tissue-isolated tumors in situ that dramatically minimizes perfusate delivery time. Our investigations demonstrated that the circadian neurohormone melatonin (MLT), eicosapentaenoic acid (EPA), and conjugated linoleic acid (CLA) inhibit growth and metabolism in several rodent and human tumors. These anticancer agents function in a receptor-mediated manner to suppress tumor uptake of linoleic acid (LA), the principal tumor growth-promoting fatty acid, and its conversion to the mitogenic agent 13-hydroxyoctadecadienoic acid (13-HODE). Using this perfusion system and MCF-7 human breast xenografts, we examined the efficacy and timing of perfusate delivery to tumors. Tumors were perfused with rat donor blood to establish baseline LA uptake values; after 36 min of perfusion, we supplemented the perfusate with MLT, EPA, or CLA and collected arteriovenous whole-blood samples over 5-min intervals for a total perfusion period of 70 min. Arterial blood pH, pO2, and pCO2 (mean+/-33.7+/-1.9, and 59.8+/-1.9 mm Hg, respectively; none of these values varied during the perfusions. Tumor LA uptake and 13-HODE production were 1.06+/-0.28 microg/min/g and 1.38+/-0.02 ng/min/g, respectively, and were completely suppressed within 5 min after delivery of anticancer agents to the tissue. This new system provides rapid perfusate delivery for use with both normal and neoplastic tissues while maintaining normal physiologic tissue parameters.

Analgesics↗
PubMed1994

[Myocardial preservation by continuous perfusion of Krebs-Henseleit solution--the temperature dependency of the optimal perfusion pressure].

The aim of this study was to determine the temperature dependency of the optimal pressure in myocardial preservation by continuous perfusion with Krebs-Henseleit bicarbonate buffer (KHBB) solution. Hearts from Wistar male rats were perfused with KHBB solution and cardiac function (aortic flow) was measured using an isolated working rat heart preparation. In the preliminary experiment, hearts were then preserved using Langendorff perfusion with KHBB solution of 37, 20 or 4 degrees C for 2 hours at a perfusion pressure of 100 cmH2O. This was followed by 15 min of Langendorff perfusion (37 degrees C, 100 cmH2O) and 20 min working perfusion. The 37 degrees C group and 20 degrees C group exhibited better functional recoveries of aortic flow (%AF) in the post-preservation period compared to the 4 degrees C group. In the test experiment, hearts were preserved using Langendorff perfusion for 4 hours at 37 degrees C or for 8 hours at 20 degrees C at various perfusion pressures. At 37 degrees C, %AF after 4 hours of the preservation were 64.7 +/- 2.6, 69.0 +/- 3.2, 81.9 +/- 3.1, 94.7 +/- 3.3 and 63.5 +/- 4.0% (p < 0.05 vs the 100 cmH2O group) at the perfusion pressure of 100, 60, 20, 15 and 10 cmH2O, respectively. %AF after 8 hours of the preservation at 15 cmH2O was 56.3 +/- 2.5%. At 20 degrees C, %AF after 8 hours of the preservatin was 78.9 +/- 3.3, 81.9 +/- 2.3, 67.4 +/- 1.9 and 65.9 +/- 2.2% (p < 0.05 vs the 60 cmH2O group) at the perfusion pressure of 60, 30, 10 and 15 cmH2O, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2002

Transient ischemic stunning of the myocardium in stress thallium-201 gated SPET myocardial perfusion imaging: segmental analysis of myocardial perfusion, wall motion and wall thickening changes.

Prolonged and persistent myocardial stunning has recently been demonstrated using technetium-99m sestamibi gated single-photon emission tomography (SPET) myocardial perfusion imaging post exercise or pharmacological stress test. In this study, we investigated the early postischemic transient myocardial stunning on early and delayed poststress thallium-201 gated SPET myocardial perfusion imaging using segmental wall motion (WM) and wall thickening (WT) analysis. A total of 1,680 segments from 84 patients' studies (53 men and 31 women, mean age 60 years) were evaluated on both early and delayed thallium-201 gated SPET treadmill exercise (59) or dobutamine stress (25) myocardial perfusion imaging. Semiquantitative analysis of perfusion, WM and WT in all segments was performed by two observers. Segments were classified according to changes in WM and WT between early and delayed images into normal, fixed abnormality, or improved abnormality (transient stunning), and were further classified according to changes in perfusion into normal, fixed defects, or ischemic. There were significant correlations between perfusion and WM, perfusion and WT, and WM and WT segmental scores on both early and delayed images. Transient stunning was seen significantly ( P < 0.001) more often in ischemic segments than were normal or fixed perfusion defects using WM (58%) and WT (50%) assessments. There was also a significant correlation between the severity of ischemia and transient stunning with either WM ( P < 0.05) or WT ( P < 0.005) evaluation. Segmental myocardial contractility assessment from gated SPET (201)Tl myocardial perfusion imaging using WM and WT was comparable, and results correlated well with the myocardial perfusion assessment. Early transient myocardial stunning was frequently observed in ischemic segments and was related to the severity of myocardial ischemia.

Adult↗
PubMed2003

Transmyocardial laser revascularization preserves regional myocardial perfusion: an MRI first pass perfusion study.

OBJECTIVE: It is controversial whether transmyocardial laser revascularization (TMLR) improves myocardial perfusion. Therefore, we assessed myocardial perfusion before and after TMLR with quantitative magnetic resonance perfusion imaging (MRPI) in an animal study. METHODS: One week after partial occlusion of the left circumflex artery (LCx) in 12 pigs, resting perfusion (ml/g/min), perfusion reserve (PR) with adenosine, regional wall thickening (RWT), cardiac output (CO) were quantified with MRI in the LCx (lateral) and LAD (septal) dependent myocardium. Subsequently, six animals were treated with TMLR of the lateral left ventricle (LV). Six animals were left untreated. A final MR was performed 8 weeks later. MRPI data were compared to microsphere-derived blood flow and % LV necrosis (TTC). 'Normal' myocardial perfusion was assessed with MRPI in 12 non-instrumented animals. RESULTS: Resting perfusion prior to TMLR (0.7-0.9+/-0.3) in the LV-lateral myocardium was preserved after TMLR (1.0+/-0.3) and decreased without TMLR (0.3+/-0.1, P<0.05). There was a significant difference (P<0.01) between the TMLR treated and untreated group. Compared to 'normals' (1.2+/-0.2) perfusion of the LV-lateral wall was not different after TMLR but reduced (P<0.02) without TMLR. PR was not different between TMLR-treated (1.4+/-0.9) and untreated (1.9+/-0.6) group but was reduced (P<0.04) compared to PR of 'normals' (2.7+/-0.8). MRPI data and microsphere-derived perfusion were significantly correlated (P<0.01). RWT in the LCx-dependent myocardium improved (P<0.02) after TMLR. CO decreased (P<0.02) and TTC-staining indicated more LV-necrosis without TMLR (6.6+/-1.6 vs. 3.7+/-1.5, P<0.01). CONCLUSION: TMLR preserves regional myocardial perfusion and improves function as shown with MRPI.

Animals↗