Use of changes in the epicardial QRS complex to assess interventions which modify the extent of myocardial necrosis following coronary artery occlusion.

Hillis, L. David; Askenazi, Joseph; Braunwald, Eugene; Radvany, Paulo; Muller, James E.; Fishbein, Michael C.; Maroko, Peter R.

doi:10.1161/01.cir.54.4.591

Cited by 136 publications

(37 citation statements)

References 39 publications

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“…However, these mapping procedures in the non-CVF treated (group I) baboons predicted subsequent severe myocardial necrosis, 24 h later. Other investigators pre-viously have demonstrated that the ST-segment elevation recorded 15 min after coronary occlusion is an excellent predictor of epicardial Q-waves 6 and 24 h later (21 (Fig. 2d).…”

Section: Discussionmentioning

confidence: 76%

Complement Localization and Mediation of Ischemic Injury in Baboon Myocardium

Pinckard¹,

et al. 1980

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Section: Discussionmentioning

confidence: 76%

Complement Localization and Mediation of Ischemic Injury in Baboon Myocardium

Pinckard¹,

et al. 1980

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“…Because the effects of GIK solution might be secondary to limitation of the area of injury, ECG mapping was obtained from the 21 (27). The group infused with mannitol did not demonstrate a significant change compared to the saline-infused animals.…”

Section: Resultsmentioning

confidence: 99%

Sustained effect of glucose-insulin-potassium on myocardial performance during regional ischemia. Role of free fatty acid and osmolality.

Ahmed¹,

Lee²,

Oldewurtel³

et al. 1978

J. Clin. Invest.

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A B S T R A C T To evaluate the influence of glucose infusate administered with insulin and potassium on left ventricular function during 4 h of ischemia, as well as mechanism of action, four groups of intact anesthetized dogs were studied. Acute crease of plasma FFA in contrast to controls which manifested a significant rise. To examine the postulate that the decrease in FFA was important to therapeutic action, a third group was infused wvith Intralipid (Cutter Laboratories, Inc., Berkeley, Calif.) and heparin, simultaneously with the glucose infusate, to effect an elevation of plasma FFA durinig ischenmia. Changes in myocardial function and electrolyte composition, as well as precordial electrocardiograimi mapping, were similar to that of animals receiving glucose alone. Because serum osmolalitv wvas increased approximately 40 mosmol during the glucose infusion, the potential role of' hyperosmolalitv was assessed by infusion of 20% mannitol during acute ischemia in a fourth group. After a transient small increase, there was a moderate decline in ftunction by 4 h, suggesting that the response to glucose is not dependent upon extracellular osmolality. Thus, it is concluded that dutring the initial hours after the onset of myocardial ischemia the gltucose infusate improves ventricular performance without evidence of arrhythmia induction or intensification of isclemiiic injury. Evoltution of irreversible necrosis appears to be delayed rather than prevented uinder the circumilstances of this study.

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“…Propranolol has been shown to exert a beneficial effect on myocardial ischemia both in experimental animals and in man (2,7,9,19,(33)(34)(35)(36)(37). Although most ofthese studies are based on indirect methods for measuring ischemic injury, in others the salutary effects of propranolol have been based on morphologic observations (34,35,37).…”

Section: Changes In Pmco2 and 127xenon Washout In Ischemic Tissuementioning

confidence: 99%

Assessment of the Efficacy of Interventions to Limit Ischemic Injury by Direct Measurement of Intramural Carbon Dioxide Tension after Coronary Artery Occlusion in the Dog

Hillis¹,

Khuri²,

Braunwald³

et al. 1979

J. Clin. Invest.

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A B S T R A C T Although nuimerous interveintions have been shown to exert a salutary effect on the ischemic inyocardium, the severity of ischemia generally has been measured by indirect techniques. In the present investigation the effect of ischemia on intramural carbon dioxide tension (PmCO2) was measured directly in the open-chest, anesthetized dog with a mass spectrometer during repetitive 10-min coronary artery occlusions separated by 45-min periods of reflow; simultaneously, regional myocardial blood flow in the ischemic area was measured by "27Xenon washout. In all dogs the increase in PmCO2 from before to 10 min after the first occlusion (APmCO2) exceeded that during subse(luent occlusions. In those dogs not receiving an intervention (controls), APmCO2 during the third occlusion was similar to that during the second occlusion. When propranolol, hyaluronidase, and nitroglycerin were administered to different groups of dogs before the third occlusion, each caused significantly smaller elevations in APmCO2 than those occurring during the control second occlusion, and the comnbination of all three interventions induced the smallest increase in APmCO2. Regional myocardial blood flow rose with hyaluronidase and was unchanged with propranolol,

show abstract

Use of changes in the epicardial QRS complex to assess interventions which modify the extent of myocardial necrosis following coronary artery occlusion.

Cited by 136 publications

References 39 publications

Complement Localization and Mediation of Ischemic Injury in Baboon Myocardium

Complement Localization and Mediation of Ischemic Injury in Baboon Myocardium

Sustained effect of glucose-insulin-potassium on myocardial performance during regional ischemia. Role of free fatty acid and osmolality.

Assessment of the Efficacy of Interventions to Limit Ischemic Injury by Direct Measurement of Intramural Carbon Dioxide Tension after Coronary Artery Occlusion in the Dog

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