Restraining infarct expansion preserves left ventricular geometry and function after acute anteroapical infarction.

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

Circulation

journal_title

Circulation

authors

Kelley ST,Malekan R,Gorman JH 3rd,Jackson BM,Gorman RC,Suzuki Y,Plappert T,Bogen DK,Sutton MG,Edmunds LH Jr

doi

10.1161/01.cir.99.1.135

subject

Has Abstract

pub_date

1999-01-05 00:00:00

pages

135-42

issue

1

eissn

0009-7322

issn

1524-4539

journal_volume

99

pub_type

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