Circulation, Vol 81, 1644-1653, Copyright © 1990 by American Heart Association
WH Gaasch, MR Zile, PK Hoshino, EO Weinberg, DR Rhodes and CS Apstein
Tolerance of the canine heart to prolonged ischemic arrest was studied in
10 hearts from normal control dogs and 15 hearts from dogs with left
ventricular hypertrophy (LVH); experiments were performed 1 year after
banding the aorta in 8-week-old puppies. At 1 year, hemodynamic studies
revealed decreased left ventricular (LV) fiber shortening and elevated
end-diastolic pressure (EDP) in five dogs (group with LVH failure); 10 dogs
exhibited normal shortening and normal EDP (group with LVH compensation).
The left ventricle-to-body weight ratio (g/kg) was 4.4 +/- 0.8 in the
control group of dogs, 7.7 +/- 1.0 in the group with LVH compensation, and
10 +/- 2.5 in the group with LVH failure. The tolerance to 60 minutes of
global ischemia (37 degrees C) followed by 90 minutes of reperfusion was
studied in an isolated blood-perfused heart apparatus (isovolumic left
ventricle, coronary perfusion pressure of 100 mm Hg). In the baseline
(preischemic) state, coronary blood flow, myocardial oxygen consumption,
lactate extraction, and myocardial high-energy phosphate content were
essentially equal in the three groups; with LV volume adjusted to produce a
systolic pressure of 100 mm Hg, there were no significant differences in
LVEDP among the three groups. During ischemia, the diastolic (asystolic)
pressure increased from 11 +/- 3 to 28 +/- 16 mm Hg (p less than 0.05) in
the group with LVH failure; however, it did not increase in the control or
the LVH compensation groups. Myocardial ATP levels declined equally in all
three groups. During early reperfusion, lactate washout was lowest in the
group with LVH failure. By 90 minutes of reperfusion, there were no
significant differences in coronary blood flow, myocardial oxygen
consumption, lactate extraction, or high-energy phosphate levels. High
diastolic pressure persisted at 90 minutes of reperfusion in the LVH
failure group (EDP was 34 +/- 19 mm Hg); however, there was no significant
change in EDP during reperfusion in the control or with LVH compensation
groups. After 90 minutes of reperfusion, developed pressures in the control
(54 +/- 9 mm Hg), the LVH compensation (49 +/- 18 mm Hg), and the LVH
failure (67 +/- 17 mm Hg) groups were not significantly different. These
data indicate that hearts with compensated LVH do not exhibit an impaired
tolerance to ischemia.(ABSTRACT TRUNCATED AT 400 WORDS)
ARTICLES
Tolerance of the hypertrophic heart to ischemia. Studies in compensated and failing dog hearts with pressure overload hypertrophy
Department of Medicine, Medical Center of Central Massachusetts, Boston.
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