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

This Article Full Text 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 Author home page(s): Hitoshi Yaku Mitsuya Murase Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kawaguchi, O. Articles by Suga, H. Search for Related Content PubMed PubMed Citation Articles by Kawaguchi, O. Articles by Suga, H.

J Thorac Cardiovasc Surg 1997;113:923-931
© 1997 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

DYNAMIC CARDIAC COMPRESSION IMPROVES CONTRACTILE EFFICIENCY OF THE HEART

Supported in part by a grant-in-aid for scientific research (07508003) from the Ministry of Education, Science, Sports, and Culture.

Received for publication Sept. 10, 1996 revisions requested Oct. 17, 1996; revisions received Nov. 5, 1996 accepted for publication Nov. 19, 1996. Address for reprints: Osamu Kawaguchi, MD, c/o Professor Mitsuya Murase, Department of Thoracic Surgery, Nagoya University School of Medicine, 65 Tsurumai, Showaku, Nagoya 466 Japan.

Abstract

The effect of dynamic cardiac compression on left ventricular contractile efficiency was assessed in terms of the pressure-volume relationship and myocardial oxygen consumption. In 11 excised cross-circulated dog hearts, the ventricle was directly compressed during systole (dynamic cardiac compression). Measurements for pressure-volume area (a measure of total mechanical energy), external work, and myocardial oxygen consumption were done before and during dynamic cardiac compression. Dynamic cardiac compression increased pressure-volume area by 28% ± 17% (mean plus or minus the standard deviation) and external work by 24% ± 20% (p = 0.0000185 and 0.0000212, respectively) at given end-diastolic and stroke volumes without affecting myocardial oxygen consumption. As a result, the oxygen cost of pressure-volume area, that is, the slope of the myocardial oxygen consumption–pressure-volume area relationship, significantly decreased by 16% ± 13% (p = 0.0000135) whereas the pressure-volume area–independent myocardial oxygen consumption was unchanged. Then, contractile efficiency, that is, the reciprocal of the slope of the myocardial oxygen consumption–pressure-volume area relationship in joules significantly improved from 45% ± 8% to 53% ± 13% (p = 0.0000437). When the native myocardial oxygen consumption–pressure-volume area relationship was assessed by subtracting the dynamic cardiac compression pressure applied to the heart, the slope of the myocardial oxygen consumption–pressure-volume area relationship returned to the control level. This indicates that the contractile efficiency of the native heart was not affected by dynamic cardiac compression. We conclude that dynamic cardiac compression enhances left ventricular pump function by improving the contractile efficiency of the overall heart leaving the energetics of the native heart unchanged.

This article has been cited by other articles:

				R. A.J. Carrington, Y. Huang, O. Kawaguchi, T. Yuasa, K. Shirota, D. Martin, and S. N. Hunyor Direct compression of the failing heart reestablishes maximal mechanical efficiency Ann. Thorac. Surg., January 1, 2003; 75(1): 190 - 196. [Abstract] [Full Text] [PDF]

				K. Shirota, Y. Huang, O. Kawaguchi, T. Yuasa, P. W. Brady, Y. Ueda, and S. N. Hunyor Functional recovery of the native heart after cardiomyoplasty in sheep with heart failure: passive and dynamic effects of volume loading Ann. Thorac. Surg., March 1, 2002; 73(3): 849 - 854. [Abstract] [Full Text] [PDF]

				M. P. Anstadt, S. A. Schulte-Eistrup, T. Motomura, E. R. Soltero, T. Takano, I. A. Mikati, K. Nonaka, F. Joglar, and Y. Nose Non-blood contacting biventricular support for severe heart failure Ann. Thorac. Surg., February 1, 2002; 73(2): 556 - 562. [Abstract] [Full Text] [PDF]

				K. Shirota, O. Kawaguchi, Y. Huang, T. Yuasa, R. Carrington, P. W. Brady, and S. N. Hunyor Ventricular remodeling after cardiomyoplasty in heart failure sheep: passive and dynamic effects Ann. Thorac. Surg., December 1, 2000; 70(6): 2102 - 2106. [Abstract] [Full Text] [PDF]

				J. H. Artrip, G.-H. Yi, J. Shimizo, E. Feihn, R. R. Sciacca, J. Wang, and D. Burkhoff Maximizing hemodynamic effectiveness of biventricular assistance by direct cardiac compression studied in ex vivo and in vivo canine models of acute heart failure J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 379 - 386. [Abstract] [Full Text] [PDF]

				J. H. Artrip, G.-H. Yi, H. R. Levin, D. Burkhoff, and J. Wang Physiological and Hemodynamic Evaluation of Nonuniform Direct Cardiac Compression Circulation, November 9, 1999; 100(90002): II-236 - 243. [Abstract] [Full Text] [PDF]

				D. R. Trumble, C. S. Park, and J. A. Magovern Copulsation Balloon for Right Ventricular Assistance : Preliminary Trials Circulation, June 1, 1999; 99(21): 2815 - 2818. [Abstract] [Full Text] [PDF]

				J. H. Artrip, J. Wang, A. R. Leventhal, J. E. Tsitlik, H. R. Levin, and D. Burkhoff Hemodynamic Effects of Direct Biventricular Compression Studied in Isovolumic and Ejecting Isolated Canine Hearts Circulation, April 27, 1999; 99(16): 2177 - 2184. [Abstract] [Full Text] [PDF]

				O. Kawaguchi, Y. Huang, T. Yuasa, C. J. Horam, R. J. Carrington, Z. Biao, P. W. Brady, M. Murase, and S. N. Hunyor Improved efficiency of energy transfer to external work in chronic cardiomyoplasty based on the pressure-volume relationship J. Thorac. Cardiovasc. Surg., June 1, 1998; 115(6): 1358 - 1366. [Abstract] [Full Text] [PDF]