Skip to main content
Journal cover image

Improved perfusion and contractile reserve after transmyocardial laser revascularization in a model of hibernating myocardium.

Publication ,  Journal Article
Hughes, GC; Kypson, AP; St Louis, JD; Annex, BH; Coleman, RE; DeGrado, TR; Donovan, CL; Lowe, JE; Landolfo, KP
Published in: Ann Thorac Surg
June 1999

BACKGROUND: Transmyocardial laser revascularization (TMR) has been demonstrated effective for relieving angina, although prior studies have yielded inconsistent results regarding postoperative myocardial perfusion and function. This study evaluated long-term changes in myocardial perfusion and contractile reserve after TMR in a model of hibernating myocardium. METHODS: Miniswine had subtotal left circumflex coronary artery occlusion to reduce resting blood flow to 10% of baseline. After 2 weeks in the low-flow state, positron emission tomography and dobutamine stress echocardiography were performed to document ischemic, viable (hibernating) myocardium in the left circumflex distribution. Animals then had sham redo thoracotomy (n = 4) or TMR (n = 6). Six months later the positron emission tomography and dobutamine stress echocardiography studies were repeated. RESULTS: Myocardial blood flow in the left circumflex distribution as measured by positron emission tomography was significantly reduced in all animals after 2 weeks in the low-flow state. In animals that had TMR, there was significant improvement in myocardial blood flow to the lased regions 6 months postoperatively. No significant change in myocardial blood flow was seen in sham animals at 6 months. Dobutamine stress echocardiography after 2 weeks of low-flow demonstrated severe hypocontractility at rest in the left circumflex region of all animals, with a biphasic response to dobutamine consistent with hibernating myocardium. In animals that had TMR, there was a trend toward improved resting function and significantly improved regional stress function in the lased segments 6 months postoperatively, consistent with a reduction in ischemia. Global left ventricular wall motion at peak stress improved significantly as well. There was no change in wall motion 6 months postoperatively in sham-operated animals. CONCLUSIONS: This study found improvements in myocardial perfusion and regional and global contractile reserve 6 months after TMR in a porcine model of hibernating myocardium. This improved perfusion and function likely accounts for the clinical benefits of the procedure.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

June 1999

Volume

67

Issue

6

Start / End Page

1714 / 1720

Location

Netherlands

Related Subject Headings

  • Tomography, Emission-Computed
  • Swine, Miniature
  • Swine
  • Respiratory System
  • Myocardial Stunning
  • Myocardial Revascularization
  • Myocardial Contraction
  • Male
  • Laser Therapy
  • Disease Models, Animal
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hughes, G. C., Kypson, A. P., St Louis, J. D., Annex, B. H., Coleman, R. E., DeGrado, T. R., … Landolfo, K. P. (1999). Improved perfusion and contractile reserve after transmyocardial laser revascularization in a model of hibernating myocardium. Ann Thorac Surg, 67(6), 1714–1720. https://doi.org/10.1016/s0003-4975(99)00317-3
Hughes, G. C., A. P. Kypson, J. D. St Louis, B. H. Annex, R. E. Coleman, T. R. DeGrado, C. L. Donovan, J. E. Lowe, and K. P. Landolfo. “Improved perfusion and contractile reserve after transmyocardial laser revascularization in a model of hibernating myocardium.Ann Thorac Surg 67, no. 6 (June 1999): 1714–20. https://doi.org/10.1016/s0003-4975(99)00317-3.
Hughes GC, Kypson AP, St Louis JD, Annex BH, Coleman RE, DeGrado TR, et al. Improved perfusion and contractile reserve after transmyocardial laser revascularization in a model of hibernating myocardium. Ann Thorac Surg. 1999 Jun;67(6):1714–20.
Hughes, G. C., et al. “Improved perfusion and contractile reserve after transmyocardial laser revascularization in a model of hibernating myocardium.Ann Thorac Surg, vol. 67, no. 6, June 1999, pp. 1714–20. Pubmed, doi:10.1016/s0003-4975(99)00317-3.
Hughes GC, Kypson AP, St Louis JD, Annex BH, Coleman RE, DeGrado TR, Donovan CL, Lowe JE, Landolfo KP. Improved perfusion and contractile reserve after transmyocardial laser revascularization in a model of hibernating myocardium. Ann Thorac Surg. 1999 Jun;67(6):1714–1720.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

June 1999

Volume

67

Issue

6

Start / End Page

1714 / 1720

Location

Netherlands

Related Subject Headings

  • Tomography, Emission-Computed
  • Swine, Miniature
  • Swine
  • Respiratory System
  • Myocardial Stunning
  • Myocardial Revascularization
  • Myocardial Contraction
  • Male
  • Laser Therapy
  • Disease Models, Animal