[en] Although reperfusion after coronary occlusion is mandatory for myocardial salvage, reperfusion may trigger a cascade of harmful events (reperfusion injury) adding to myocardial injury. We investigated effects of reperfusion on left ventricular (LV) haemodynamics and ventriculo-arterial (VA) coupling in pigs following acute myocardial ischaemia induced by coronary artery occlusion. Experiments were performed in six animals, with measurements of cardiac and arterial function at baseline, after 60 min of ischaemia (T60) and after 2 (T180) and 4 h of reperfusion (T300). Ventriculo-arterial coupling was assessed using the ventriculo-arterial elastance ratio of paper, as well as using a 'stiffness coupling' and 'temporal coupling' index. Reperfusion following ischaemia (T180 versus T60) induced a progressive decline in cardiovascular function, evidenced by a decrease in mean arterial blood pressure, cardiac output and ejection fraction which was not restored at T300. Although reperfusion also induced an increase in slope of the end-systolic pressure-volume relationship (ESPVR), the ESPVR curve shifted to the right, associated with a depression of contractile function. Histology demonstrated irreversible myocardial damage at T300. The ventriculo-arterial elastance ratio and the 'stiffness coupling' index were unaffected throughout the protocol, but the 'temporal coupling' parameter indicated a relative shift between heart period and the time constant of the arterial system. It is unlikely that these alterations are attributable to ischaemic injury alone. The combination of both the stiffness and temporal coupling index may provide more information when studying ventriculo-arterial coupling than the more commonly used ventricular end-systolic stiffness/effection arterial elastance (E-es/E-a) ratio.
Desaive, Thomas ; Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Verdonck, Pascal; Ghent University > Institute Biomedical Technology > Cardiovascular Mechanics and Biofluid Dynamics
D'Orio, Vincenzo ; Université de Liège - ULiège > Département des sciences cliniques > Médecine d'urgence - bioch. et phys. hum. normales et path.
Kolh, Philippe ; Université de Liège - ULiège > Services généraux (Fac. de psycho. et des sc. de l'éducat.) > Relations académiques et scientifiques (Psycho et sc.éduc.) - Relations académiques et scientifiques (Sciences)
Language :
English
Title :
Cardiovascular haemodynamics and ventriculo-arterial coupling in an acute pig model of coronary ischaemia-reperfusion
Baan J, van der Velde ET, de Bruin HG, Smeenk GJ, Koops J, van Dijk AD et al. (1984). Continuous measurement of left ventricular volume in animals and humans by conductance catheter. Circulation 70, 812-823.
Boersma E, Maas ACP, Deckers JW & Simoons ML (1996). Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet 348, 771-775.
Cerra FB, Lajos TZ, Montes M & Siegel JH (1975). Hemorrhagic infarction: a reperfusion injury following prolonged myocardial ischemic anoxia. Surgery 78, 95-104.
Denslow S (1996). Relationship between PVA and myocardial oxygen consumption can be derived from thermodynamics. Am J Physiol Heart Circ Physiol 270, H730-H740.
Dogné JM, Rolin S, Petein M, Tchana-Sato V, Ghuysen A, Lambermont B et al. (2005). Characterization of an original model of myocardial infarction provoked by coronary artery thrombosis induced by ferric chloride in pig. Thromb Res 116, 431-442.
Garcia-Dorado D (2004). Myocardial reperfusion injury: a new view. Cardiovasc Res 61, 363-364.
Glower D, Spratt J, Snow TR, Kabas JS, Davis JW, Olsen C et al. (1985). Linearity of the Frank-Starling relationship in the intact heart: the concept of preload recruitable stroke work. Circulation 71, 994-1009.
Grant B & Paradowski L (1987). Characterization of pulmonary arterial input impedance with lumped parameter models. Am J Physiol Heart Circ Physiol 252, H585-H593.
Hearse DJ, Humphrey SM, Nayler WG, Slade A & Border D (1975). Ultrastructural damage associated with reoxygenation of the anoxic myocardium. J Mol Cell Cardiol 7, 315-324.
Higo K, Sano J, Karasawa A & Kubo K (1993). The novel thromboxane A2 receptor antagonist KW-3635 reduces infarct size in a canine model of coronary occlusion and reperfusion. Arch Int Pharmacodyn Ther 323, 32-49.
Kamimura R, Miura N & Suzuki S (2003). The hemodynamic effects of acute myocardial ischemia and reperfusion in Clawn miniature pigs. Exp Anim 52, 335-338.
Khalil P, Neuhof C, Huss R, Pollhammer M, Khalil M, Neuhof H et al. (2005). Calpain inhibition reduces infarct size and improves global hemodynamics and left ventricular contractility in a porcine myocardial ischemia/reperfusion model. Eur J Pharm 528, 124-131.
Kolh P, Lambermont B, Ghuysen A, D'Orio V, Gerard P, Morimont P et al. (2003). Alteration of left ventriculo-arterial coupling and mechanical efficiency during acute myocardial ischemia. Int Angiol 22, 148-158.
Kolh P, Lambermont B, Ghuysen A, Tchana-Sato V, Dogne JM, Hanson J et al. (2005). Effects of dobutamine on left ventriculoarterial coupling and mechanical efficiency in acutely ischemic pigs. J Cardiovasc Pharmacol 45, 144-152.
Kolh P, Rolin S, Tchana-Sato V, Petein M, Ghuysen A, Lambermont B et al. (2006). Evaluation of BM-573, a novel TXA2 synthase inhibitor and receptor antagonist, in a porcine model of myocardial ischemia-reperfusion. Prostaglandins Other Lipid Mediat 79, 53-73.
Lambermont B, D'Orio V, Gerard P, Kolh P, Detry O & Marcelle R (1998). Time domain method to identify simultaneously parameters of the windkessel model applied to the pulmonary circulation. Arch Physiol Biochem 106, 245-252.
Metzsch C, Liao Q, Steen S & Algotsson L (2006). Myocardial glycerol release, arrhythmias and hemodynamic instability during regional ischemia-reperfusion in an open chest pig model. Acta Anaesthesiol Scand 50, 99-107.
Newby K (1997). Clinical outcomes according to time to treatment. Clin Cardiol 20, III11-III15.
Opie LH (1989). Reperfusion injury and its pharmacologic modification. Circulation 80, 1049-1062.
Piper HM, Abdallah Y & Schäfer C (2004). The first minutes of reperfusion: a window of opportunity for cardioprotection. Cardiovasc Res 61, 365-371.
Piper HM, Garcia-Dorado D & Ovize M (1998). A fresh look at reperfusion injury. Cardiovasc Res 38, 291-300.
Rolin S, Petein M, Tchana-Sato V, Dogne JM, Benoit P, Lambermont B et al. (2003). BM-573, a dual thromboxane synthase inhibitor and thromboxane receptor antagonist, prevents pig myocardial infarction induced by coronary thrombosis. J Pharmacol Exp Ther 306, 59-65.
Sagawa K, Maughan L, Suga H & Sunagawa K (1988). Cardiac Contraction and the Pressure-Volume Relationship. Oxford University Press, New York.
Schaper W, Görge G, Winkler B & Schaper J (1988). The collateral circulation of the heart. Prog Cardiovasc Dis 31, 57-77.
Segers P, Stergiopulos N & Westerhof N (2002). Relation of effective arterial elastance to arterial system properties. Am J Physiol Heart Circ Physiol 282, 1041-1046.
Steendijk P, Van der Velde ET & Baan J (1993). Left ventricular stroke volume by single and dual excitation of conductance catheter in dogs. Am J Physiol Heart Circ Physiol 264, H2198-H2207.
Stergiopulos N, Meister JJ & Westerhof N (1996). Determinants of stroke volume and systolic and diastolic pressure. Am J Physiol Heart Circ Physiol 270, H2050-H2059.
Suga H, Kitabatake A & Sagawa K (1979). End-systolic pressure determines stroke volume from fixed end-diastolic volume in the isolated canine left ventricle under a constant contractile state. Circ Res 44, 238-249.
Taylor IM, Shaikh NA & Downar E (1984). Ultrastructural changes of ischemic injury due to coronary artery occlusion in the porcine heart. J Mol Cell Cardiol 16, 79-94.
Wang QD, Penrow J, Sjoquist PO & Ryden L (2002). Pharmacological possibilities for protection against myocardial reperfusion injury. Cardiovasc Res 55, 25-37.
White F & Bloor C (1981). Coronary collateral circulation in the pig: correlation of collateral flow with coronary bed size. Basic Res Cardiol 76, 189-196.
Zweier J & Talukder M (2006). The role of oxidants and free radicals in reperfusion injury. Cardiovasc Res 70, 181-190.