Oct 11, 1992

The stretched ventricle. Myocardial creep and contractile dysfunction after acute nonischemic ventricular distention

The Journal of Thoracic and Cardiovascular Surgery
S W DowningL H Edmunds

Abstract

The hypothesis that nonischemic distention of the arrested, flaccid ventricle causes myocardial creep and reduces ventricular contractile force was tested in 16 sheep. Left ventricular volume was calculated from ultrasonic dimension transducers spanning left ventricular major and minor axes and left ventricular wall thickness. Changes in left ventricular volume were plotted against left ventricular pressure, with and without temporary occlusion of both venae cavae before and after nonischemic distention of the continuously perfused, flaccid nonbeating left ventricle arrested with oxygenated, normothermic blood-potassium perfusate. During 12 minutes of cardiac arrest, an apical balloon progressively distended the left ventricle to a peak pressure of 40 mm Hg in 11 sheep using a protocol designed to prevent subendocardial ischemia or mechanical injury. Coronary sinus lactate measurements and myocardial distribution of microspheres confirmed the absence of ischemia in 16 animals. In five control sheep the balloon was inserted but not inflated. Left ventricular volume at zero pressure increased from 5.9 +/- 3.5 to 9.5 +/- 4.4 ml (p < 0.05) after balloon inflation and did not change in the control animals. After maximum distention o...Continue Reading

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Mentioned in this Paper

Ischemia
Myocardial Contraction
Stress, Mechanical
Ventricular Dysfunction, Left
Dall Sheep
Left Ventricular Function
Cardiac Volume
Lactation Disorders
Ventricular Dysfunction
Diastole

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