James E. Davies, MD, Stanley B. Digerness, PhD, Cheryl R

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Presentation transcript:

Multiple Treatment Approach to Limit Cardiac Ischemia-Reperfusion Injury James E. Davies, MD, Stanley B. Digerness, PhD, Cheryl R. Killingsworth, DVM, PhD, Corinne Zaragoza, MS, Charles R. Katholi, PhD, Robert K. Justice, PhD, Steven P. Goldberg, MD, William L. Holman, MD The Annals of Thoracic Surgery Volume 80, Issue 4, Pages 1408-1416 (October 2005) DOI: 10.1016/j.athoracsur.2005.04.022 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Data (pre-drug/pre-ischemia, left anterior descending region) used to calculate preload recruitable work area (PRWA) are shown. Complexes marked by an “X” on the zero line of the first derivative of left ventricular pressure with respect to time (DPDT) channel were used for analysis. (B) Loops depicting segment length (x-axis) versus left ventricular pressure (y-axis). (C) Pressure at end diastole was chosen by an automated process and displayed as a function of end-diastolic length (EDL). The maximum EDL identified during the experiment was identified as the xmax. The slope, xmax, and intercept were used to calculate PRWA. (3–4 and 7–8 = channels recording sonomicrometry crystal excursion; ECG = electrocardiogram; LVP = left ventricular pressure; SW = stroke work.) The Annals of Thoracic Surgery 2005 80, 1408-1416DOI: (10.1016/j.athoracsur.2005.04.022) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A–C) Data from sample time number 2 (post-drug/pre-ischemia) are shown. (3–4 and 7–8 = channels recording sonomicrometry crystal excursion; DPDT = first derivative of left ventricular pressure with respect to time; ECG = electrocardiogram; EDL = end-diastolic length; LVP = left ventricular pressure.) The Annals of Thoracic Surgery 2005 80, 1408-1416DOI: (10.1016/j.athoracsur.2005.04.022) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The area of left ventricular infarction expressed as a percentage of the area at risk is shown for each heart, together with the group mean and standard deviation. • = individual/animals; ○ = group mean ± standard deviation. (Cont Rpf = controlled reperfusion.) The Annals of Thoracic Surgery 2005 80, 1408-1416DOI: (10.1016/j.athoracsur.2005.04.022) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Regional preload recruitable work area (PRWA) for the left circumflex coronary distribution is shown for the five determinations during the study (see text). • = control; ○ = cariporide; ▾ = diazoxide; ▿ = controlled reperfusion; ■ = combination; measurement events: 1 = prior to cardiopulmonary bypass; 2 = after aortic root infusion of test drug or vehicle, or both dimethyl sulfoxide; 3, 4, 5 at 30, 60, and 120 minutes after initiation of reperfusion. The Annals of Thoracic Surgery 2005 80, 1408-1416DOI: (10.1016/j.athoracsur.2005.04.022) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Regional preload recruitable work area (PRWA) for the left anterior descending coronary distribution is shown for the 5 determinations during the study. • = control; ○ = cariporide; ▾ = diazoxide; ▿ = controlled reperfusion; ■ = combination; measurement events: 1 = prior to cardiopulmonary bypass; 2 = after aortic root infusion of test drug or vehicle, or both dimethyl sulfoxide; 3, 4, 5 at 30, 60, and 120 minutes after initiation of reperfusion. The Annals of Thoracic Surgery 2005 80, 1408-1416DOI: (10.1016/j.athoracsur.2005.04.022) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions