Circulation Research · 1979 · 1.3K citations · 24 references
MedicineCardiologyPhysiologyClinical CardiologyHemodynamic ManagementInterventional CardiologyCardiac PhysiologyCardiovascular PathophysiologyCardiovascular PhysiologyHeart FailureHemodynamicsIschemic Heart DiseaseCardiac OutputCardiac Output ChangesInfarct Size AssessmentInfarct Size QuantificationLeft Ventricular FailureLeft Ventricular PhysiologyLeft Ventricular Systolic FunctionReduced Cardiac Output
The study aimed to determine how infarct size affects ventricular function in rats 21 days after left coronary artery occlusion. Ventricular performance was measured under ether anesthesia by baseline hemodynamics and peak indices during volume loading and aortic occlusion, while infarct size was quantified by planimetry of four histological LV slices. Rats with infarcts ≤30 % showed no functional impairment, moderate infarcts (31–46 %) had normal baseline but reduced peak flow and pressure, and infarcts >46 % led to congestive heart failure, illustrating a direct correlation between myocardial loss and ventricular dysfunction.
To define the relationship between infarct size and ventricular performance, we performed hemodynamic studies in rats 21 days after left coronary artery occlusion. Ventricular performance was assessed under ether anesthesia by measurements of baseline hemodynamics and stressed performance as determined by the peak cardiac output and stroke volume obtained during intravenous volume loading and by the peak left ventricular developed pressure obtained during occlusion of the ascending aorta. Infarct size was determined by planimetry of the endocardial circumference of each of four histological slices of the left ventricle. Rats with small (4-30%) myocardial infarctions had no discernible impairment in either baseline hemodynamics or peak indices of pumping and pressure-generating ability when compared to the sham-operated, noninfarcted rats. Rats with moderate (31-46%) infarctions had normal baseline hemodynamics but reduced peak flow indices and developed pressure. Rats with infarctions greater than 46% had congestive heart failure, with elevated filling pressures, reduced cardiac output, and a minimal capacity to respond to pre- and after load stresses. The entire spectrum of postinfarction ventricular function was observed, from no detectable impairment to congestive failure. In this model of histologically healed myocardial infarction, the impairment of left ventricular function was directly related to the loss of myocardium.
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