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European Heart Journal 1994 15(3):424-433;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Myocardial contraction patterns in non-ischaemic and ischaemic regions during acute coronary insufficiency

S. BIRKELAND, J. WESTBY, K. MATRE*, S FAERESTRAND* and K. GRONG

*Surgical Research Laboratory, Department of Surgery and Department of Medicine Norway
University of Bergen, Haukeland Hospital Norway

Received 24 February 1993; revised 19 October 1993; .

Correspondence Sigurd Birkeland. MD, Surgical Research Laboratory, University of Bergen; Haukeland Hospital, N-5021 Bergen, Norway

Abstract

The effect of coronary insufficiency on the myocardial contraction pattern was studied in 11 thoractomized cats using apical long axis echocardiograms and cross-oriented segments in the anterior midwall. Myocardial tissue blood flow was studied using radiolabelled microspheres. After circumflex coronary artery occlusion, ejection shortening increased on average 17% for circumferential segments (P<0•05) and 61% for longitudinal segments (P<0•001). Hyperkinesis was also validated as augmented anterior endocardial wall motion and wall thickening. Circumflex occlusion increased end-systolic sphericity of the left ventricle (P<0•05). Subsequent underperfusion of the left coronary artery, in two discrete steps, decreased subendocardial blood flow by, on average, 36% (P<0•001) and 75% (P<0•001) vs the post-occlusion value, while subepicardial flow did not change. While subendocardial blood flow decreased by 36%, systolic shortening of the global major axis decreased, by, on average, 77% (P<0•001), shortening of the longitudinal segments by 36% (P<0•001), and systolic shortening of the minor axis by 18% (P<0•05), whereas shortening of midwall circumferential segments did not change. This study shows that changes in myocardial contraction in both non-ischaemic and ischaemic regions during coronary insufficiency are most pronounced in the direction of the cardiac major axis.

Key Words: Myocardial contraction • centreline method • myocardial ischaemia • acute ventricular remodelling


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