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PubMed1983

[Left ventricular function following revascularization for occlusion of a coronary artery lasting 1 to 2 hours].

The time-lag between coronary occlusion and irreversible damage to the myocardium is ill-defined in man. In 10 patients the changes in left ventricular function have been studied after coronary occlusion during diagnostic or therapeutic cardiac catheterization of 1-2 hours' duration. Revascularization was achieved either surgically or through intracoronary streptokinase infusion. The interval between occlusion and onset of extracorporal circulation or reopening was 61 to 119 minutes. Despite enzyme elevation (CPK, CK-MB, SGOT) and appearance of Q-waves in 5 patients, no significant alteration of left ventricular function was noted on repeat cardiac catheterization 10 to 230 days after the accident. These observations, suggest that coronary occlusion of 1-2 hours' duration fails to produce significant irreversible damage to the myocardium despite electrocardiographic and enzymatic signs of myocardial infarction.

Aspartate Aminotransferases↗
PubMed1986

Left ventricular function in tricuspid atresia: a radionuclide study.

Left ventricular function was evaluated by radionuclide angiocardiography in patients with tricuspid atresia before and after the Fontan operation. Ejection fraction was 0.54 +/- 0.13 in 29 patients without the Fontan procedure and 0.56 +/- 0.14 in 14 postoperative patients. Group means were not statistically different, but both were less than normal values for the institution (p less than 0.001). Function did not correlate significantly with age or aortic oxygen saturation. Serial studies demonstrated little change in eight of nine patients examined over 1 to 3 years preoperatively. From the preoperative group of nine patients with abnormal ejection fraction, three underwent surgery, with two survivors. Although 5 of 14 patients had abnormal systolic function after the Fontan operation, only 1 was symptomatic. Depressed response to isometric exercise was found in two patients with a normal ejection fraction at rest. Group systolic function after Fontan surgery did not correlate significantly with age at surgery but all patients were operated on at more than 5 years of age. Of seven patients studied both preoperatively and postoperatively two had an increase and three a decrease in ejection fraction. The trend in these seven studied serially after surgery was toward early improvement in ejection fraction. This study shows variability in left ventricular performance in patients with tricuspid atresia before and after surgery. Individuals undergoing the Fontan procedure after 5 years of age do not necessarily have an increase in ejection fraction over preoperative values, and may even have a decrease. Serial improvement over early postoperative results may be expected, without significant deterioration, during the next 1 to 3 years.

Adolescent↗
PubMed1990

Investigation on the relation of impedance rheopneumogram with pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease.

In order to investigate the relation of impedance rheopneumogram with pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease (COPD), we measured impedance rheopneumogram and performed right heart catheterization on 150 COPD patients simultaneously both at rest and during exercise test. The results showed that impedance rheopneumogram was mainly influenced by right ventricular after-load while the influences of right ventricular pre-load, right ventricular contractivity, right ventricular work index and cardiac output were rather slight. These results also suggest that in COPD patients impedance rheopneumogram is of great value when used to predict pulmonary arterial pressure but of little value when used to measure the right ventricular function.

Aged↗
PubMed2001

Use of propranolol in heart failure patients: safety, tolerability, and effects on left ventricular function.

INTRODUCTION AND OBJECTIVES: Beta-blockers have been shown to improve prognosis in patients with heart failure (HF). Propranolol, which is a low-cost drug, has not been fully studied in this setting. We sought to determine the safety, tolerability and effects on left ventricular function observed with the use of propranolol in HF patients, in functional class II-IV of the New York Heart Association. POPULATION AND METHODS: Prospective study in which 20 outpatients (10 male, mean age 56 +/- 12 years, ranging from 20 to 70) were included. Mean left ventricular ejection fraction (EF) was 28%. Safety, tolerability and effects on electrocardiographic and echocardiographic variables were analyzed. Patients were evaluated in three steps: a) Step I--optimization on conventional drugs and assessment of baseline parameters; b) Step II--start of propranolol (10-20 mg/day), increasing the dose weekly to achieve a heart rate of 60 bpm, or a maximum daily dose of 120 mg; c) Step III--reappraisal of the parameters analyzed in step I, after 3 months of propranolol treatment. RESULTS: On average, after treatment with propranolol, EF increased by 52% (p = 0.0003), E wave deceleration time was prolonged by 62% (p = 0.001) and effective ventricular filling time increased by 38.5% (p = 0.0005). Two patients developed mild congestion which was controlled by increasing diuretic doses, with no need to interrupt the protocol. Four patients had bradycardia-related symptoms, controlled by reducing digoxin doses. Nine subjects developed hyperkalemia, reversed by interrupting or reducing spironolactone. CONCLUSION: Propranolol was safe and well tolerated, and had beneficial effects on ventricular function in HF patients. Its impact on mortality requires further study.

Adrenergic beta-Antagonists↗
PubMed1990

Left ventricular function in the early postoperative stage--cardioplegic baneful effect is lost in the first 24 hours.

Early postoperative left ventricular function was investigated in 42 patients with left ventricular volume overload caused by valvular regurgitation. Preoperatively, left ventricular contractile function, stroke work and stress relations were all evaluated. Anoxic index (AnI) was considered as an index of myocardial preservation. Postoperatively, the cardiac function was estimated as the left ventricular stroke work index (SWI) after 3, 6, 24 and 48 hours of post-cardiopulmonary bypass. The release of CK-MB isoenzyme was also measured at the same time as an indication of myocardial injury. AnI and the postoperative SWI3 and SWI6 showed negative correlations in 6 hours, while preoperative SWI0 and postoperative SWI24 and SWI48 showed positive correlations after 24 hours, and SWI0 showed positive or negative correlations to the preoperative 8 parameters. It was observed that ejection fraction, end-systolic wall stress to end-systolic volume index ratio and tension volume ejection showed positive, while left ventricular end-diastolic pressure showed negative correlations to SWI48. However, none of these indexes showed any significant correlations during the first 24 hours following surgery. On the other hand, AnI and the total release of CK-MB isoenzyme showed a positive correlation. These data suggest that the cardioplegic baneful effect on cardiac function might be lost in the first 24 hours after surgery.

Female↗
PubMed1988

[Development of left ventricular function following aortic valve replacement].

Changes in left ventricular function were evaluated in twelve patients with aortic valve stenosis and in eleven patients with aortic valve regurgitation in order to find out whether the results obtained soon after aortic valve replacement persisted over a long period. All patients had been provided with a St-Jude Medical valve. Evaluation included electrocardiography, radiography of the chest, phonocarotidography and echocardiography and was performed preoperatively, then three months and five years on average in each patient after surgery. In patients with aortic valve stenosis, the left ventricular mass clearly regressed during the first three months (p less than 0.01) and continued to regress, albeit not significantly, over five years. In patients with aortic valve regurgitation, the left ventricular volume and mass regressed significantly during the first three months and remained normal for five years. No significant variation in systolic performance was observed in both groups. In spite of good overall results, 26 p. 100 of the patients had an unfavourable long-term outcome as they developed major left ventricular dilatation. Nos prosthesis dysfunction was observed, and the St Jude Medical valve caused little obstruction. Thus, with this little obstructive prosthesis the postoperative improvement obtained persisted for five years in most cases of aortic valve stenosis or regurgitation.

Aortic Valve Insufficiency↗
PubMed2003

[Left ventricular functional parameters using ECG-gated multidetector spiral CT in comparison with invasive ventriculography].

PURPOSE: To evaluate the accuracy of left ventricular function using a multidetector CT (MDCT) with retrospective ECG-gating and to compare the results with conventional ventriculography. MATERIALS AND METHODS: In 26 patients, retrospectively ECG-gated MDCT of the heart (Volume Zoom, Siemens, Germany) as well as conventional coronary angiography including ventriculography was performed to exclude or follow coronary artery disease. CT examination (120 KV, 400 mAs) was carried out with 4 x 1 mm collimation (500 ms gantry rotation time). For CT angiography, 150 ml of contrast media was injected intravenously at a flow rate of 4 ml/s. All data sets of the functional cardiac parameters were reconstructed in end-systolic and end-diastolic phase. End-systolic volume (ESV), end-diastolic volume (EDV) and ejection fraction (EF) were determined from multiplanar reformations orthogonally through the cardiac short axis and analyzed using special evaluation software (ARGUS, Siemens). The results were compared with ESV, EDV and EF obtained from invasive ventriculography. RESULTS: In all cases, a sufficient quality of the MDCT images was achieved. EDV (150.1 +/- 16.2 ml MDCT vs. 138.7 +/- 16.9 ml ventriculography; mean difference 11.4 +/- 12.7 ml; r = 0.51) had an acceptable correlation to conventional ventriculography, and ESV (58.1 +/- 14.6 ml vs. 50.2 +/- 13.4 ml; mean difference 7.9 +/- 8.8 ml; r = 0.81) and EF (60.9 +/- 13.6 % vs. 64.9 +/- 12.7 %; mean difference 4.0 +/- 6.2 %; r = 0.79) showed a good correlation. In comparison with invasive ventriculography, MDCT tended to overestimate significantly EDV (p = 0.008) and ESV (p = 0.003) and to underestimate EF (p = 0.001). CONCLUSION: MDCT of the heart with retrospective ECG-gating enables efficient estimation of left ventricular function, providing important additional information of non-invasive cardiac imaging using MDCT. However, EDV and EVS were significantly overestimated and EF was underestimated in MDCT compared to ventriculography.

Aged↗
PubMed1975

Effect of propranolol on left ventricular function, segmental wall motion, and diastolic pressure-volume relation in man.

Precise quantitation of the effects of the non-selective beta adrenergic blocking drug propranolol (3.15 mg/kg body weight) on left ventricular function, segmental wall motion, and diastolic pressure-volume relation in man has been performed. High fidelity left ventricular pressure measurements and simultaneous single-plane angiocardiograms were recorded on a video disc and volumes calculated by a light-pen computer system. Systolic segmental wall motion was computer analysed using the long axis-quadrasection method. Patients were transvenously atrially paced to maintain a constant heart rate. The haemodynamic effects of propranolol may vary depending upon the extent of pre-existing myocardial disease. In some patients ventricular function, as measured by ejection fraction, may be reduced. This reduction in ejection fraction appears to result from overall reduction in segmental wall motion, but also from accentuation of segmental wall abnormalities. These results are consistent with the thesis that beta adrenergic blocking drugs may inhibit compensatory sympathetic mechanisms. The diastolic effects of propranolol may include quite substantial increases in ventricular volumes in those patients with impaired cardiac function. With respect to the intact human ventricle, propranolol may increase diastolic volume for a given level of ventricular pressure. Thus, in a static sense, the ventricle in these patients could be viewed as being more compliant after propranolol administration. However, the fact that the length-tension relation, as measured by the slope of the logarithmic pressure versus volume plot is unaltered by propranolol, suggests that the muscle comprising the ventricle itself exhibits no alteration in its passive elastic properties.

Angiocardiography↗
PubMed1991

[Cardiac response to exercise before and after coronary artery bypass grafting: evaluation by continuous ventricular function monitor].

Cardiac response to exercise was evaluated with continuous ventricular function monitor (VEST) with cadmium telluride detector. Thirty-nine patients (30 male and 9 female, aged 57 +/- 8, 23 had old myocardial infarction) were monitored with VEST during and after supine ergometer exercise before and 4 weeks after coronary artery bypass grafting (CABG). Left ventricular ejection fraction (EF) responses were classified into 4 types; type A showed EF increase greater than 5% till end of exercise, type B demonstrated initial increase followed by decrease in EF, type C revealed no significant EF change, type D showed continuous EF decrease. Before CABG, each EF response type A, B, C, and D consisted of 4, 2, 12, 21 patients respectively and after CABG each type included 18, 10, 9, 2. The EF change from rest to peak exercise (delta EF-Ex) improved from -6.4 +/- 8.8% to 5.0 +/- 7.4% (p less than 0.001) after CABG. All patients showed rapid EF increase after exercise or "EF overshoot" (EF-OS). After CABG, the EF change from rest to EF-OS (delta EF-OS) and time to EF-OS (T-OS) were improved from 9.9 +/- 5.2% to 14.9 +/- 5.3% (p less than 0.001) and 162 +/- 86 sec to 80 +/- 48 sec (p less than 0.001) respectively. Type A, B patients showed higher delta EF-OS and shorter T-OS than type C, D patients, suggesting EF overshoot was contingent upon cardiac function during exercise. After CABG, in patients with myocardial infarction, T-OS shortened but delta EF-OS showed less improvement than patients without infarction, suggesting loss of myocardium hampered EF-OS.

Aged↗
PubMed1993

Evaluation of the effects of different cardioplegic techniques on left ventricular function during coronary artery bypass surgery using transesophageal echocardiography.

Fifty consecutive patients undergoing coronary artery bypass grafting surgery were studied to evaluate the effect of intermittent anterograde cold cardioplegia (IACCH) and intermittent combined anterograde-retrograde cold cardioplegia (IRCCN) on left ventricular function using transesophageal echocardiography. Global function did not significantly change in both groups, but significantly more inotropes were required in IACCH. Newly developed abnormalities of regional wall motion after cardiopulmonary bypass, which were indicative of ischemic myocardium, were detected in the segments supplied by the right coronary artery in both groups (IACCH, 20%; IRCCN, 16%), by the left circumflex coronary artery only in IACCH (12%) and by the left anterior descending coronary artery only in IRCCN (12%). It is concluded that although global evaluation of left ventricular function did not show any significant change after IACCH and IRCCN under routine management, analysis of abnormalities of regional wall motion provided specific information. In both groups, complete protection of the myocardium was not achieved, and the characteristics of poorly protected areas were dependent on the difference in the two methods. Myocardium supplied by the right coronary artery seemed to be particularly vulnerable, and a special effort to protect these segments is mandatory for a successful outcome.

Aged↗
PubMed1991

[Noninvasive evaluation of left ventricular function in alcoholics before and after suspension of ethanol abuse].

It is known that chronic alcoholism causes morphological changes of the myocardium before the development of a specific dilated cardiomyopathy. We studied a group of chronic alcoholics, with normal arterial pressure and without clinical evidence of liver cirrhosis, to evaluate left ventricular function, both before and after withdrawal of ethanol. A M-B mode echo recording of the left ventricle and left ventricular inflow Doppler velocimetry with carotid pulse tracing was performed in each patient within 24 hours of the last alcohol consumption and after a period of abstinence at least 3 weeks. We analysed parameters of left ventricular systolic and diastolic functions, in comparison with a group of normal subjects well matched for age, body surface area and heart rate. The results showed that, in the group of alcoholics, a cardiac hypertrophy exists with increased left ventricular mass and normal parameters of left systolic ventricular function, but with altered ratio PEP/LVET. This last result is the consequence of an abnormal left diastolic ventricular function, as demonstrated from the analysis of the Doppler indexes of left ventricular filling (lower ratio E/A). Left ventricular inflow Doppler velocimetry showed different results in alcoholics and control subjects in the early diastolic flow velocity peak (61 +/- 12 vs 84 +/- 8) and in the peak flow velocity in the atrial contraction phase (62 +/- 10 vs 40 +/- 5.6). We have not observed any change of the echocardiographic parameters after the short period of alcohol withdrawal. We advance the hypothesis that there is an altered diastolic function depending, not only on the hypertrophy of the myocardium, but also on the myocardial interstitial involvement caused by ethanol.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Does left ventricular function improve with L-carnitine after acute myocardial infarction?

A double blind randomized placebo controlled clinical trial was carried out to assess the efficacy and safety of L-carnitine in patients suffering from acute anterior wall myocardial infarction with respect to left ventricular function. Sixty patients (34 men, 26 women, mean age 56+11 yr.) with acute anterior wall myocardial infarction were randomized to placebo and L-carnitine. All the patients were given intravenous L-carnitine / placebo in the dose of 6gm/day for the first seven days followed by oral L-carnitine / placebo 3 gm/day in three divided doses for a period of three months. Echocardiography was performed for regional wall motion abnormality, left ventricular end systolic volume (ESV), end diastolic volume (EDV) and ejection fraction (EF) on admission, after seven days and after three months of the infarction. Forty-four patients completed the study. There were three deaths, two in the placebo and one in the L-carnitine group (p>0.05). Thirteen patients were lost to follow up. Echo parameters in both groups were comparable (p>0.05). The duration of chest pain prior to initiation of the I.V. L-carnitine was 7.5 + 5.2 hrs in the L-carnitine group and 7 + 4 hrs in the placebo group (p>0.05). There was no statistical difference in the EF, ESV and EDV on admission, at discharge and after three months in the L-carnitine and the placebo groups (p>0.05). No significant adverse effects were noted. L-carnitine, though a safe drug, does not affect the left ventricular function in patients with myocardial infarction.

Aged↗
PubMed1997

Highland mountain hiking and coronary artery disease: exercise tolerance and effects on left ventricular function.

Physical exercise has become a well-established concept in the secondary prevention of coronary artery disease. We investigated the exercise requirements of extensive highland mountain hiking (8.7 km, 470 m to 1220 m over sea level, average incline 8.5%, mean walking velocity < 3 km x h-1) in 11 regularly exercising male patients with history of MI and stable coronary artery disease (CAD; mean age +/- SD:61.0 +/- 3.9 yr) and 9 age-matched male healthy controls (CO; mean age +/- SD:61.2 +/- 5.0 yr). All subjects underwent continuous ECG monitoring; arterial blood pressure and blood lactate concentrations were measured several times during mountain hiking. Before and after exercise, cardiac dimensions and functions were assessed by two-dimensional echocardiography and Doppler echocardiography. The mean exercise levels for heart rate and blood lactate were compared with the corresponding data of a multistage upright cycle ergometry. Clinical manifestations of coronary insufficiency, left ventricular myocardial dysfunction, or cardiac arrhythmias > Lown IIIb were not observed in any case. No significant differences in left atrial and left ventricular dimensions and no changes in systolic left ventricular function compared with the preexercise values were found after the mountain hike tour. Doppler echocardiography demonstrated significant changes in diastolic left ventricular function in CAD, but not in CO. The peak exercise intensity during mountain hiking was equivalent to a workload of 100-125 W (1.25-1.5 W x kg-1 body weight) in a multistage upright cycle ergometry. Extensive highland mountain hiking may be a low risk alternative within the outpatient rehabilitation program for secondary prevention of CAD for MI patients with a cycle ergometric exercise tolerance > 1.5 W x kg-1 body weight.

Aged↗
PubMed1991

Assessment of ventricular function with first-pass radionuclide angiography using technetium 99m hexakis-2-methoxyisobutylisonitrile: a European multicentre study.

In the context of a multicentre study on the use of technetium 99m hexakis-2-methoxyisobutylisonitrile (99mTc-Sestamibi), we evaluated the accuracy of the ventricular function assessed at rest by means of first-pass radionuclide angiocardiography acquired during the injection of the tracer for myocardial perfusion scintigraphy. The results were compared with first-pass studies performed using reference tracers sodium pertechnetate Tc 99m or technetium 99m diethylene triamine penta-acetic acid or with gated radionuclide angiocardiography. A total of 66 patients of the 105 enrolled in the study could be evaluated. The comparison of the first-pass studies was possible in 33 subjects with regard to the left ventricular ejection fraction, yielding r = 0.909 (P less than 10(-6)), and in 22 cases with regard to the right ventricular ejection fraction, yielding r = 0.712 (P less than 0.001). The comparison between the first-pass study using 99mTc-Sestamibi and the equilibrium gated radionuclide angiocardiography was possible for the left ventricular ejection fraction in 26 cases, with r = 0.937 (P less than 10(-6)), and for the right ventricular ejection fraction in 15 subjects, with r = 0.783 (P less than 0.001). In conclusion, the assessment of ventricular function performed by acquiring a first-pass radionuclide angiocardiograph during the injection of 99mTc-Sestamibi for perfusion myocardial scintigraphy can be considered reliable and accurate, when compared with the usually employed techniques. This result confirms the feasibility of a combined evaluation of perfusion and function at rest and during stress testing, which represents one of the most interesting advantages offered by the use of 99mTc-Sestamibi.

Coronary Disease↗
PubMedDate not supplied

Assessment of left ventricular function by a power index: an intraoperative study.

To investigate whether left ventricular performance can be described independent of loading conditions, twelve patients underwent intraoperatively two cineangiographies of the left ventricle with simultaneous pressure recordings. The first ventriculography was performed with ejecting left ventricle without assistance by the extracorporeal circulation. The second one was performed with ejecting left ventricle partially unloaded by the extracorporeal circulation. Myocardial perfusion pressure (mean aortic pressure) was held constant. Due to this procedure marked decreases in preload (end-diastolic wall stress: -54%) and modest changes in afterload (mean systolic wall stress: -23%) were achieved. End-diastolic volume index was reduced from 84 ml/m2 to 57 ml/m2, whereas end-systolic volume index decreased slightly from 33 ml/m2 to 29 ml/m2. Left ventricular end-diastolic pressure decreased from 12 mm Hg to 7 mm Hg, while peak pressure remained nearly unchanged. Usual parameters of ejection phase (EF, Vmw) as well as power per wall volume (PW) were markedly affected by unloading. In contrast to these parameters, the power index (PI), i.e., the ratio of power per wall volume and end-diastolic wall stress, remained unchanged when left ventricular preload was reduced: PI under control: 5.2 +/- 1.8 sec-1; PI under unloading: 5.2 +/- 1.5 sec-1. This power index can easily be determined from routine angiographies. It may provide a new approach to the assessment of left ventricular function in man.

Adult↗
PubMed1985

Stress ventricular function test in conscious, nonthoracotomised dogs to assess cardiac drug efficacy.

The measurement of left ventricular (LV) function is frequently performed in unconscious or thoracotomised animals in the resting state; these conditions may seriously affect the basal haemodynamic state. To assess myocardial function in conscious animals, a technique was developed to place a catheter across the atrial septum into the left ventricle without a thoracotomy. A stress ventricular function test (SVFT) was performed by raising the systemic blood pressure with methoxamine in the conscious dog. In order to demonstrate the effectiveness of the SVFT in the detection of a decrease in ventricular function, a SVFT was performed before and after the acute infusion of verapamil to determine resting and reserve LV function. A slope relating systolic aortic pressure to the LV end-diastolic pressure was obtained in 10 dogs using a low dose (0.005) and in four dogs a high dose (0.01 microgram X kg-1 X min-1) verapamil (V). The mean slope before V was 3.6 +/- 1.2 and after 2.0 +/- 0.92 (p less than 0.001). The day-to-day variability of the SVFT was less than 22% (coefficient of variability). The SVFT is a sensitive, reproducible method to assess resting and increased or decreased myocardial contractility and is useful in selecting appropriate doses of cardiac drugs to determine their effect on the myocardium during acute and chronic infusion studies in the conscious, nonthoracotomised dog.

Animals↗
PubMed2006

Quantification of global left ventricular function: comparison of multidetector computed tomography and magnetic resonance imaging. a meta-analysis and review of the current literature.

Cardiac morbidity and mortality are closely related to cardiac volumes and global left ventricular (LV) function, expressed as left ventricular ejection fraction. Accurate assessment of these parameters is required for the prediction of prognosis in individual patients as well as in entire cohorts. The current standard of reference for left ventricular function is analysis by short-axis magnetic resonance imaging. In recent years, major extensive technological improvements have been achieved in computed tomography. The most marked development has been the introduction of the multidetector CT (MDCT), which has significantly improved temporal and spatial resolutions. In order to assess the current status of MDCT for analysis of LV function, the current available literature on this subject was reviewed. The data presented in this review indicate that the global left ventricular functional parameters measured by contemporary multi-detector row systems combined with adequate reconstruction algorithms and post-processing tools show a narrow diagnostic window and are interchangeable with those obtained by MRI.

Humans↗
PubMed2004

Plasma brain natriuretic peptide reflects left ventricular function during percutaneous cardiopulmonary support.

BACKGROUND: Plasma levels of brain natriuretic peptide (BNP), a cardiac hormone secreted predominantly from the ventricle, are elevated in patients with myocardial infarction, hypertension, and dilated cardiomyopathy. In this study, we assessed the usefulness of measuring BNP to evaluate left ventricular function in patients with severe heart failure receiving mechanical circulatory support. METHODS: Plasma BNP and creatine kinase (CK)-MB levels were measured serially in 8 consecutive patients with cardiogenic shock who received percutaneous cardiopulmonary support (PCPS) at Osaka Police Hospital from August 1999 to March 2000. Coronary artery bypass grafting or percutaneous transluminal coronary angioplasty was also performed in 5 patients during PCPS; in addition, 1 patient underwent insertion of a left ventricular venting catheter and implantation of a left ventricular assist system after PCPS. RESULTS: Five patients were weaned from PCPS, and 3 died. In survivors, plasma BNP and CK-MB levels correlated positively and significantly (r = 0.968, p = 0.03). After PCPS was initiated, plasma BNP levels gradually decreased in survivors, but not in patients who died (p = 0.003). CONCLUSIONS: These results suggest that plasma BNP levels accurately reflect myocardial damage in patients undergoing PCPS. A decrease in BNP might appear to indicate improved left ventricular function and predict successful weaning from mechanical support.

Adult↗