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Modeling ischemia-induced dyssynchronous myocardial contraction

Strum, DP and Pinsky, MR (2006) Modeling ischemia-induced dyssynchronous myocardial contraction. Anesthesia and Analgesia, 103 (4). 846 - 853. ISSN 0003-2999

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Left ventricular (LV) contraction dyssynchrony is not easily quantified. We previously described a model for quantifying LV dyssynchrony that referenced regional amplitude and phase angles to global LV systole using esmolol-induced regional dyskinesis. We tested the hypothesis that our sine wave model and phase angle analysis of regional dyssynchrony in a canine model could also assess dyssynchrony of contraction during regional ischemia. Hence we compared intracoronary esmolol and matched regional ischemia in 10 anesthetized open-chest dogs. Regional and total LV volumes (conductance catheter), piezoelectric crystal shortening, and LV pressures were measured before, during, and after esmolol-induced apical dyskinesis and matched regional ischemia. We defined regional phase angle of contraction (α) as the relative distance, measured in degrees, that regional minimal volume differed from global end-systole. We also compared maximal stroke volume (SV), observed effective SV (that portion of regional SV contributing to total SV for each treatment), and calculated effective SV (total regional SV x cosine α). Dobutamine infusion increased homogeneity of regional α relative to baseline. Both esmolol and ischemia significantly delayed (P < 0.05) apical contraction as quantified by increased α (12.4° ± 28.1° to 27.4° ± 30.4° and 54.2° ± 32.6°, respectively) (mean ± sd) and decreased regional effective SV (4.7 ± 2.5 mL to 3.6 ± 2.2 mL and 4 ± 2.5 mL, respectively) relative to baseline. Our study indicates that intracoronary esmolol and ischemia induced qualitatively similar mechanical effects on myocardial function and that a sine wave model to estimate regional effective SV is a sensitive method to detect and quantify regional dyssynchrony induced by ischemia. Potentially, phase angle and regional amplitude analyses may prove to be effective measures to identify and quantify the beneficial effects of resynchronization therapies on myocardial function. © 2006 by International Anesthesia Research Society.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Strum, DP
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 October 2006
Date Type: Publication
Journal or Publication Title: Anesthesia and Analgesia
Volume: 103
Number: 4
Page Range: 846 - 853
DOI or Unique Handle: 10.1213/01.ane.0000232440.59426.aa
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0003-2999
Other ID: 10.1213/01.ane.0000232440.59426.aa
PubMed ID: 17000791
Date Deposited: 05 Apr 2012 21:15
Last Modified: 30 Jan 2020 16:55


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