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J Thorac Cardiovasc Surg 1998;115:1209-1214
© 1998 Mosby, Inc.
CARDIOPULMONARY SUPPORT AND PHYSIOLOGY |
Supported in part by U.S. Public Health Service grant 1 RO1 HL-48109.Dr. Dickstein is supported by National Institutes of Health NRSA training grantHL09325-01.
Received for publication July 28, 1997. Revisions requested Oct. 6, 1997. Revisions received Dec. 24, 1997. Accepted for publication Dec. 29, 1997. Address for reprints: Henry M. Spotnitz, MD, Department of Surgery,Columbia University, College of Physicians and Surgeons, 622 West 168th St., PH1422, New York, NY 10032.
Objective: This study examines theresolution of iatrogenic edema and related changes in systolic and diastolicproperties in the intact pig left ventricle. Methods:The coronary arteries were perfused for 50 to 60 seconds with diluted blood(hematocrit value 10% ± 1%, edema group,n = 5) or whole blood (hematocrit value 28%± 1%, control group, n = 6)infused into the aortic root during aortic crossclamping in conditioned,anesthetized pigs. After whole blood reperfusion, preload reduction by venacaval occlusion was used to define systolic and diastolic properties at15-minute intervals. Left ventricular pressure and conductance, aortic flow, andtwo-dimensional echocardiography were recorded.
Results:Left ventricular mass (wall volume) in the edema group increased significantlycompared with that in control pigs after crossclamp removal. Mass returned topreperfusion levels after 45 minutes. The ventricular stiffness constant (ß)increased significantly in the edema group versus the control group, returningto baseline by 30 minutes. The diastolic relaxation constant (
) and baseconstant (
) did not differ between groups. There was no significantchange in contractility.
Conclusion:Increases in left ventricular mass and diastolic stiffness induced by coronaryperfusion with hemodiluted blood resolve after 45 minutes of whole bloodperfusion in pigs. This study defines physiologic effects of edema in the normalheart while eliminating most common confounding experimental errors. (J ThoracCardiovasc Surg 1998;115:1209-14)
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