HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chitwood, W. R. Articles by Wechsler, A. S. Search for Related Content PubMed PubMed Citation Articles by Chitwood, W. R., Jr Articles by Wechsler, A. S.

The Journal of Thoracic and Cardiovascular Surgery, Vol 85, 595-605, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Diastolic ventricular properties in patients during coronary revascularization. Intermittent ischemic arrest versus cardioplegia

WR Chitwood Jr, RC Hill, JD Sink and AS Wechsler

Left ventricular diastolic properties were examined in 24 patients undergoing coronary revascularization with either 32 degrees C intermittent ischemic arrest (IA) or 4 degrees C potassium cardioplegia (CP) for myocardial protection. The ages, numbers of grafts, and preoperative cardiac function were similar for the two groups of patients. For compliance data, hearts were filled passively during bypass perfusion to diastolic pressures between 0 and 20 mm Hg by clamping the left ventricular vent. Simultaneously, minor axis dimensions were measured with 8 mm epicardial ultrasonic crystals. End- diastolic lengths (EDL), normalized to a Lagrangian strain definition (epsilon), were compared at each pressure (P) by the nonlinear regression equation, P = alpha(e beta epsilon-1). Both elastic constants, alpha and beta, as well as linear regression slopes (k) of pressure-strain data were compared as indices of ventricular stiffness. Prior to determinations, the EDL at 0 mm Hg transmural pressure was defined as l0. At each filling pressure, a leftward shift in the compliance curve developed following IA but not CP. Moreover, shifts in alpha, beta, and k constants occurred with IA alone, l0 did not change in either group. Therefore, stiffening did not occur when CP was used for protection, despite ischemic durations twice those of IA (31 versus 15 minutes). These data confirm CP to be a superior method of cardiac protection during coronary bypass grafting and show diastolic ventricular properties to be a sensitive indicator of subclinical ischemic injury.

This article has been cited by other articles:

				A. A. Alsaddique Recognition of diastolic heart failure in the postoperative heart Eur J Cardiothorac Surg, December 1, 2008; 34(6): 1141 - 1148. [Abstract] [Full Text] [PDF]

				M. M. R. Amirhamzeh, D. A. Dean, C.-X. Jia, S. E. Cabreriza, J. P. Starr, M. J. Sardo, N. Chalik, M. L. Dickstein, and H. M. Spotnitz Iatrogenic Myocardial Edema: Increased Diastolic Compliance and Time Course of Resolution In Vivo Ann. Thorac. Surg., September 1, 1996; 62(3): 737 - 743. [Abstract] [Full Text]

				C. A. Caldarone, I. B. Krukenkamp, P. G. Burns, G. R. Gaudette, J. Schulman, and S. Levitsky Blood cardioplegia in the senescent heart J. Thorac. Cardiovasc. Surg., February 1, 1995; 109(2): 269 - 274. [Abstract] [Full Text]

				M. M. R. Amirhamzeh, C.-X. Jia, J. P. Starr, R. Sciacca, N. C. Chowdhury, D. T. Hsu, and H. M. Spotnitz Diastolic function in the heterotopic rat heart transplant model Effects of edema, ischemia, and rejection J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 928 - 937. [Abstract] [Full Text]

				R. M. Bodenhamer, R. G. Johnson, J. D. Randolph, G. Pohost, C. Boucher, R. Okada, E. Lowenstein, F. H. Levine, and W. M. Daggett The Effect of Adding Mannitol or Albumin to a Crystalloid Cardioplegic Solution: A Prospective, Randomized Clinical Study Ann. Thorac. Surg., October 1, 1985; 40(4): 374 - 379. [Abstract] [PDF]