Abstract:
BACKGROUND:Expansion of an acute myocardial infarction predicts progressive left ventricular (LV) dilatation, functional deterioration, and early death. This study tests the hypothesis that restraining expansion of an acute infarction preserves LV geometry and resting function. METHODS AND RESULTS:In 23 sheep, snares were placed around the distal left anterior descending and second diagonal coronary arteries. In 12 sheep, infarct deformation was prevented by Marlex mesh placed over the anticipated myocardial infarct. Snared arteries were occluded 10 to 14 days later. Serial hemodynamic measurements and transdiaphragmatic quantitative echocardiograms were obtained up to 8 weeks after anteroapical infarction of 0.23 of LV mass. In sheep with mesh, circulatory hemodynamics, stroke work, and end-systolic elastance return to preinfarction values 1 week after infarction and do not change subsequently. Ventricular volumes and ejection fraction do not change after the first week postinfarction. Control animals develop large anteroapical ventricular aneurysms, increasing LV dilatation, and progressive deterioration in circulatory hemodynamics and ventricular function. At week 8, differences in LV end-diastolic pressure, cardiac output, end-diastolic and end-systolic volumes, ejection fraction, stroke work, and end-systolic elastance are significant (P<0.01) between groups. CONCLUSIONS:Preventing expansion of acute myocardial infarctions preserves LV geometry and function.
journal_name
Circulationjournal_title
Circulationauthors
Kelley ST,Malekan R,Gorman JH 3rd,Jackson BM,Gorman RC,Suzuki Y,Plappert T,Bogen DK,Sutton MG,Edmunds LH Jrdoi
10.1161/01.cir.99.1.135subject
Has Abstractpub_date
1999-01-05 00:00:00pages
135-42issue
1eissn
0009-7322issn
1524-4539journal_volume
99pub_type
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