Regional contraction improves, then declines after reperfusion of ischemic myocardium in the dog. 1994

C W Buffington, and S Watanabe
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh, Pennsylvania.

Myocardial ischemia occurs during cardiac surgery and coronary artery angioplasty. If ischemia is short-term or the heart is protected, cellular necrosis can be avoided. Nevertheless, myocardial stunning occurs and can reduce cardiac performance in the hours after ischemia. Such stunning is preceded by a short period of normal or above normal contraction immediately after reperfusion. The time course of this phenomenon was investigated in six anesthetized dogs subjected to a 10-minute total coronary occlusion. Regional contraction was measured in the ischemic zone and in a remote zone of the heart with a sonomicrometer. Remote zone contraction increased during ischemia, returned toward baseline values after reperfusion, and was stable for the next hour, indicating little effect of time on the experimental preparation. In contrast, ischemic zone contraction was abolished by 10 minutes of coronary occlusion, returned to baseline or greater levels within 1 to 3 minutes following release of the occlusion, then gradually declined over 10 to 20 minutes to a level about 40% below baseline values, indicating myocardial stunning. These findings support the notion that a honeymoon period of normal or above normal function exists during early reperfusion, and that stunning manifests later. This reperfusion "honeymoon" may create a false sense of security.

UI MeSH Term Description Entries
D009200 Myocardial Contraction Contractile activity of the MYOCARDIUM. Heart Contractility,Inotropism, Cardiac,Cardiac Inotropism,Cardiac Inotropisms,Contractilities, Heart,Contractility, Heart,Contraction, Myocardial,Contractions, Myocardial,Heart Contractilities,Inotropisms, Cardiac,Myocardial Contractions
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D015425 Myocardial Reperfusion Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing MYOCARDIAL REPERFUSION INJURY. Coronary Reperfusion,Reperfusion, Myocardial,Coronary Reperfusions,Myocardial Reperfusions,Reperfusion, Coronary,Reperfusions, Coronary,Reperfusions, Myocardial
D016277 Ventricular Function, Left The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance. Left Ventricular Function,Function, Left Ventricular,Functions, Left Ventricular,Left Ventricular Functions,Ventricular Functions, Left
D017202 Myocardial Ischemia A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION). Heart Disease, Ischemic,Ischemia, Myocardial,Ischemic Heart Disease,Disease, Ischemic Heart,Diseases, Ischemic Heart,Heart Diseases, Ischemic,Ischemias, Myocardial,Ischemic Heart Diseases,Myocardial Ischemias
D017682 Myocardial Stunning Prolonged dysfunction of the myocardium after a brief episode of severe ischemia, with gradual return of contractile activity. Hibernation, Myocardial,Myocardial Hibernation,Stunned Myocardium,Myocardium, Stunned,Stunning, Myocardial

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