Circulation, Vol 54, 64-70, Copyright © 1976 by American Heart Association
JS Forrester, HL Wyatt, PL Da Luz, JV Tyberg, GA Diamond and HJ Swan
To evaluate the progression of segment function following induction of
ischemia, the left anterior descending coronary artery was ligated (eight
dogs) or cannulated and perfused at various pressures via a
bypass-oxygenator (six dogs). Mercury-in-silastic length gauges were
sutured to the anterior left ventricle, and pressure was recorded by a
catheter-tipped transducer. Segment function was determined from the area
of the pressure-length loop by plotting instantaneous left ventricular
pressure against segment length and by evaluation of the degree of systolic
shortening. Segment function decreased linearly as flow in the left
anterior descending artery was decreased in a stepwise fashion by reduction
in perfusion pressures from 100 to 20 mm Hg. With both left anterior
descending coronary artery ligation and stepwise flow reduction, the
pressure-length loop invariably showed four clearly identifiable
morphologic patterns which relate conceptually to the specific left
ventricular contraction patterns: dyssynchrony, hypokinesis, akinesis, and
paradoxic systolic expansion. Re-oxygenation following occlusion invariably
revealed return to a normal pattern in reverse order. This study
demonstrates that a consistent and predictable progression of segmental
contraction abnormalities occurs with ischemia.
ARTICLES
Functional significance of regional ischemic contraction abnormalities
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