Mehrdad M. R. Amirhamzeh, MD, David A

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Iatrogenic Myocardial Edema: Increased Diastolic Compliance and Time Course of Resolution in Vivo Mehrdad M.R. Amirhamzeh, MD, David A. Dean, MD, Chao-Xiang Jia, MD, Santos E. Cabreriza, MBA, Joanne P. Starr, MD, Michael J. Sardo, BA, Natalya Chalik, BA, Marc L. Dickstein, MD, Henry M. Spotnitz, MD The Annals of Thoracic Surgery Volume 62, Issue 3, Pages 737-743 (August 1996) DOI: 10.1016/S0003-4975(96)00391-8 Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 1 Representative short-axis cross sections of the left ventricle just below the mitral valve immediately before (A) and after (B) coronary perfusion with Plegisol. Electrocardiogram (lowest tracing), left ventricular conductance (tracing at center of figure), and left ventricular pressure (highest tracing) are also illustrated. Increase in left ventricular mass is represented by an increase in cross-sectional area of the myocar-dial ring. The Annals of Thoracic Surgery 1996 62, 737-743DOI: (10.1016/S0003-4975(96)00391-8) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 2 Representative pressure-volume loops constructed for a pig left ventricle (LV) in the edema group at baseline. The slopes (Ees) of end-systolic pressure-volume relationships (ESPVR) at baseline and three time points after blood reperfusion are shown. Changes in Ees and its volume intercept (Vo(e)) are indicated in the figure. While changes in Ees were minimal, leftward shifts of Vo(e) may be indicative of mild depression in contractility. The Annals of Thoracic Surgery 1996 62, 737-743DOI: (10.1016/S0003-4975(96)00391-8) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 3 Average left ventricular (LV) end-diastolic pressure-volume relationships in the control group for three time intervals. Changes in average α and β constants used to calculate these curves were not statistically significant. (LVEDP = left ventricular end-diastolic pressure; LVEDV = left ventricular end-diastolic volume; VF = ventricular fibrillation.) The Annals of Thoracic Surgery 1996 62, 737-743DOI: (10.1016/S0003-4975(96)00391-8) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 4 Average left ventricular (LV) end-diastolic pressure-volume relationships in the edema group for three time intervals. Change in average α constants are not statistically significant. The average β constants increased significantly 16 to 45 minutes after Plegisol administration and returned to normal during the 46- to 90-minute time period, indicating reversible increases in LV stiffness during the period of edema. (LVEDP = left ventricular end-diastolic pressure; LVEDV = left ventricular end-diastolic volume.) The Annals of Thoracic Surgery 1996 62, 737-743DOI: (10.1016/S0003-4975(96)00391-8) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions