TY - JOUR
T1 - Intraaortic Balloon Counterpulsation
T2 - Its Influence Alone and Combined with Various Pharmacological Agents on Regional Myocardial Blood Flow during Experimental Acute Coronary Occlusion
AU - Jett, G. K.
AU - Dengle, S. K.
AU - Barnett, P. A.
AU - Platt, M. R.
AU - Willerson, J. T.
AU - Watson, J. T.
AU - Eberhart, R. C.
N1 - Funding Information:
From the Department of Surgery, University of Texas Health Science Center, Dallas, TX. Supported in part by Grant HL 17669 from the Ischemic Heart Disease Specialized Center of Research (SCOR), National Heart, Lung, and Blood Institute. Accepted for publication June 11, 1980. Address reprint requests to Dr. Eberhart, Department of Surgery, University of Texas Health Science Center, 5323 Hany Hines Blvd, Dallas, TX 75235.
PY - 1981
Y1 - 1981
N2 - We investigated the separate and combined effects of pharmacological and intraaortic balloon pump (IABP) support on regional myocardial blood flow in an experimental model of acute myocardial ischemia. Chloralose-anesthetized dogs were ventilated with an oxygen-air mixture, and cardiac output, arterial pressure, and heart rate were held constant. Treatment was begun 20 minutes following permanent ligation of the left anterior descending coronary artery (LAD). We evaluated the following pharmacological interventions: 25% hypertonic mannitol, isosorbide dinitrate, methyl-prednisolone sodium succinate, and propranolol. We measured left ventricular hemodynamics and intramyocardial blood flow by the radioactive microsphere technique prior to treatment and at 15-minute intervals thereafter. Compared with control measurements 20 minutes following LAD ligation, collateral blood flow to ischemic myocardium tended to decrease with no treatment. Treatments with the four pharmacological interventions and with IABP alone produced no significant improvement in collateral blood flow to ischemic myocardium 15 minutes following treatment. In contrast, mannitol, isosorbide dinitrate, and propranolol, each combined with IABP support, produced significant improvements in collateral flow within the same time periods. In nonischemic myocardium, combined pharmacological and IABP treatment did not enhance myocardial blood flow above that obtained with the pharmacological agents alone. The most effective combination of mechanisms for improving the ischemic region's myocardial blood flow appeared to be a reduction of extra-vascular coronary flow resistance coupled with a simultaneous increase in diastolic arterial pressure.
AB - We investigated the separate and combined effects of pharmacological and intraaortic balloon pump (IABP) support on regional myocardial blood flow in an experimental model of acute myocardial ischemia. Chloralose-anesthetized dogs were ventilated with an oxygen-air mixture, and cardiac output, arterial pressure, and heart rate were held constant. Treatment was begun 20 minutes following permanent ligation of the left anterior descending coronary artery (LAD). We evaluated the following pharmacological interventions: 25% hypertonic mannitol, isosorbide dinitrate, methyl-prednisolone sodium succinate, and propranolol. We measured left ventricular hemodynamics and intramyocardial blood flow by the radioactive microsphere technique prior to treatment and at 15-minute intervals thereafter. Compared with control measurements 20 minutes following LAD ligation, collateral blood flow to ischemic myocardium tended to decrease with no treatment. Treatments with the four pharmacological interventions and with IABP alone produced no significant improvement in collateral blood flow to ischemic myocardium 15 minutes following treatment. In contrast, mannitol, isosorbide dinitrate, and propranolol, each combined with IABP support, produced significant improvements in collateral flow within the same time periods. In nonischemic myocardium, combined pharmacological and IABP treatment did not enhance myocardial blood flow above that obtained with the pharmacological agents alone. The most effective combination of mechanisms for improving the ischemic region's myocardial blood flow appeared to be a reduction of extra-vascular coronary flow resistance coupled with a simultaneous increase in diastolic arterial pressure.
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U2 - 10.1016/S0003-4975(10)61534-2
DO - 10.1016/S0003-4975(10)61534-2
M3 - Article
C2 - 6779721
AN - SCOPUS:0019351432
SN - 0003-4975
VL - 31
SP - 144
EP - 154
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 2
ER -