Left ventricular catecholamines during acute myocardial infarction in the dog

1987 ◽  
Vol 65 (2) ◽  
pp. 172-178 ◽  
Author(s):  
W. Reuben Kaufman ◽  
Bodh I. Jugdutt
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Left Ventricular ◽  
Normal Myocardium ◽  
Radioenzymatic Assay ◽  
Coronary Ligation ◽  
Anesthetized Dogs ◽  
Norepinephrine Depletion

To determine whether changes in left ventricular catecholamine content occur during the first 30 to 90 min of acute myocardial infarction, myocardial catecholamine (radioenzymatic assay) over the interval was studied in the dog. In nine pentobarbital-anesthetized opened-chest dogs without coronary ligation, myocardial catecholamine at 2.5 h after pentobarbital (i) consisted mainly of norephinephrine (87% total catecholamine), (ii) showed a base to apex gradient in norephinephrine (1.44 ± 0.10 vs. 1.03 ± 0.10 μg/g, p < 0.05) and dopamine (0.20 ± 0.03 vs. 0.12 ± 0.02 μg/g, p < 0.05) but not epinephrine (0.017 vs. 0.016 μg/g), and (iii) showed no difference in norepinephrine, dopamine, or epinephrine across basal, mid, and apical left ventricular transverse planes spanning the vascular territories of the two coronary arteries. In 18 pentobarbital-anesthetized dogs with coronary ligation, (i) norepinephrine, measured in 14 regions across the mid left ventricle after 90 min ischemia in four dogs, was less in the ischemic center of the occluded bed than normal myocardium (1.01 ± 0.04 vs. 1.29 ± 0.04 μg/g, p < 0.05), and (ii) norepinephrine was unchanged in normal myocardium of 14 dogs at 30, 60, 90 min, and 48 h but decreased in ischemic myocardium by 31% at 60 min (0.89 ± 0.10 vs. 1.29 ± 0.08 μg/g, p < 0.025) and 79% at 48 h (0.27 ± 0.04 vs. 1.26 ± 0.08 μg/g, p < 0.001). Thus, norepinephrine depletion from ischemic but not normal myocardium is detectable by 60 min during acute myocardial infarction.

scholarly journals Takotsubo cardiomyopathy: case report

2017 ◽  
Vol 95 (7) ◽  
pp. 663-668
Author(s):  
Marina G. Matveeva ◽  
G. E. Gogin ◽  
M. N. Alekhin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular ◽  
Classical Type ◽  
Coronary Microvascular Dysfunction ◽  
Apical Ballooning Syndrome ◽  
Coronary Syndrome

This article reports a clinical case of Takotsubo cardiomyopathy manifest clinically, biochemicaly, electrocardiographically, and echocardiographicalyas acute myocardial infarction. The diagnosis was based on finding intact coronary arteries and rapid positive dynamics of instrumental and laboratory data. Takotsubo cardiomyopathy (CMP) (stress-associated CMP, apical ballooning syndrome) is a rare reversible disease developing after acute emotional and physical stress. Its prevalence is estimated at 1-2% of all cases of acute myocardial infarction. It most commonly affects postmenopausal women. The clinical picture is similar to that of acute coronary syndrome with transient hypo- and akinesiaof apical and middle segments of the left ventricle (LV) in combination with hyperkinesia of its basal myocardial segment in the absence of stenosis or a spasm of coronary arteries. The precise pathophysiology of the disease is unknown; several hypotheses are proposed including enhancedsympathoadrenal activity, catecholamine multivesselepicardial coronary artery spasm, coronary microvascular dysfunction, catecholamine cardiotoxicity and catecholamine-mediated myocardial stunning. The Mayo Clinic diagnostic criteria are most widely used in clinical practice: transient hypokinesia, akinesia, or dyskinesia of left ventricular mid-segments with or without apical involvement; regional wall motion abnormalities extending beyond the region of blood supply of a single epicardialartery; a stressful event oftenbut not always present in the medical history in the absence of obstructive coronary disease or angiographic evidence of acute plaque rupture; new electrocardiographic abnormalities (either ST-segment elevation and/or T-wave inversion) or modest elevation in cardiac troponin 1 level; the absence of pheochromocytoma and myocarditis. Takotsubo cardiomyopathyhas been classified into 3 types based on the involvement of the left ventricle: classical type, reverse type and mid-ventricular type; lesions of right ventricle are also described. Specific treatment of the disease is unavailable, and the main purpose of therapy is normalization of LV systolic function. The prognosis of Takotsubo cardiomyopathyis favorable, complete clinical recovery is observed in 95,5% of the cases, the average time of recovery is between 2 and 3 weeks.

Fibromuscular dysplasia of the coronary arteries: a rare cause of death in infants and young children

2015 ◽  
Vol 26 (1) ◽  
pp. 202-205 ◽  
Author(s):  
Carolin Mogler ◽  
Wolfgang Springer ◽  
Matthias Gorenflo
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Left Coronary Artery ◽  
Fibromuscular Dysplasia ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Severe Left Ventricular Dysfunction ◽  
Infants And Young Children

AbstractFibromuscular dysplasia is a common vascular disease, which mainly affects the renal arteries. In this study, we report the case of a 1-day-old infant who presented with severe left ventricular dysfunction immediately after birth, and subsequently died 3 days postnatally. At autopsy, an extensive myocardial infarction of the left ventricle and the septum was found, caused by an isolated fibromuscular dysplasia of left coronary artery.

A prosthetic myocardium for repair of localized defects of the left ventricle: Concept and hemodynamic feasibility

1980 ◽  
Vol 3 (3) ◽  
pp. 173-179
Author(s):  
A. Kantrowitz ◽  
T. Igari ◽  
I. Hayashi ◽  
P.S. Freed
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Experimental Investigation ◽  
Left Ventricle ◽  
Treatment Plan ◽  
Surgical Excision ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Surgical Approaches ◽  
Left Ventricular Myocardium

As an approach to the treatment of patients with large but circumscribed akinetic or dyskinetic regions in the left ventricular myocardium as sequelae of acute myocardial infarction, excision of the defect and implantation of a mechanical functional equivalent of myocardium is suggested. Experimental investigation of this technique is described. Hemodynamic data from a series of dog experiments indicate that activation of the prosthetic myocardium after excision of the left ventricle is followed by improvement in various hemodynamic parametres of interest Although substantial experimental work must be completed and difficult bioengineering problems solved, preliminary results have encouraged us to continue our investigations of the prosthetic myocardium. An imposing array of treatment methods is now available to the clinician who must deal with the sequelae of acute myocardial infarction. Selecting from pharmacologic, electrophysiologic, and surgical approaches the physician can in many instances design a treatment plan precisely tailored to the clinical problem. Large left ventricular aneurysms and their functional equivalents of ventricular dyskinesis or hypokinesis continue, however, to represent a class of problems in which established techniques have been less then satisfactory. Surgical excision with closure of the defect is regarded as effective for small aneurysms, but such procedures may so compromise cardiac output in patients with large ones as to be unacceptable. Unfortunately, it is just the latter group in which medical palliation is least likely to be effective in managing congestive failure, angina, and other pathophysiologic manifestations. A relatively unsual approach derived from in-series techniques of mechanical assistance to the failing circulation (1) offers the theoretical possibility of a treatment tailored to the problem of a large ventricular aneurysm. Experimental investigation of this technique in the Surgical Research Laboratory at the Sinai Hospital of Detroit has progressed to the point that a report of our experiences to date may be of interest.

scholarly journals Computed Tomographic Assessment of Coronary Arteries in Patients Undergoing Stem Cell Therapy Following an Acute Myocardial Infarction

2017 ◽  
Vol 2 (2) ◽  
pp. 136-139
Author(s):  
Erzsébet Lázár ◽  
Lehel Bordi ◽  
István Benedek ◽  
Monica Chițu ◽  
Zsuzsanna Suciu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Stem Cell ◽  
Cell Therapy ◽  
Coronary Arteries ◽  
Stem Cell Therapy ◽  
Systolic Function ◽  
Treatment Strategies ◽  
Left Ventricular

AbstractDespite of numerous treatment strategies developed in the last years, ischemic heart disease remains the leading cause of death around the world. Acute myocardial infarction (MI) causes irreversible destruction to the myocardial tissue, which is replaced by fibroblast cells, leading to the formation of a dense, collagenous scar, a non-contractile tissue, and often to heart failure. Stem cell therapy seems to represent the next therapeutic method for the treatment of heart failure caused by myocardial infarction. Several international trials proved the beneficial outcome of the intracoronary infusion of bone marrow-derived stem cells, improving left ventricular systolic function and clinical symptomatology. Many noninvasive imaging procedures are available to evaluate the beneficial properties of stem cell therapy. Most studies have demonstrated the role of multislice computed tomography (MSCT) in evaluating left ventricular parameters such as end-diastolic and end-systolic volumes and ejection fraction, or to quantify myocardial scar tissue. In this review we will discuss the usefulness of MSCT for the assessment of coronary arteries, new tissue regeneration, and evaluation of tissue changes and their functional consequences in subjects undergoing stem cell treatment following MI.

scholarly journals Shunt Between the Ventricular Chamber and Coronary Arteries Preserves Left Ventricular Function in Acute Myocardial Infarction

2002 ◽  
Vol 66 (7) ◽  
pp. 633-633
Author(s):  
Shoichi Miyamoto ◽  
Masatoshi Fujita ◽  
Kinzo Ueda ◽  
Shun-ichi Tamaki ◽  
Koji Hasegawa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Coronary Arteries ◽  
Left Ventricular

Left Ventricular Assist System Through the Left Ventricle for Acute Myocardial Infarction: Report of a Case

Surgery Today ◽  
2006 ◽  
Vol 36 (7) ◽  
pp. 615-618
Author(s):  
Hiroki Hata ◽  
Goro Matsumiya ◽  
Yoshiki Sawa ◽  
Norihide Fukushima ◽  
Osamu Monta ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Left Ventricular ◽  
Left Ventricular Assist System ◽  
Ventricular Assist ◽  
Left Ventricular Assist

scholarly journals Survival after Left Ventricular Free Wall Rupture in an Elderly Woman with Acute Myocardial Infarction Treated Only Medically

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Víctor Hugo Roa-Castro ◽  
Ervin Molina-Bello ◽  
Hector Valenzuela-Suárez ◽  
Tobías Rotberg-Jagode ◽  
Nilda Espinola-Zavaleta
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Left Ventricular ◽  
Ventricular Free Wall ◽  
Free Wall ◽  
Left Ventricular Free Wall ◽  
Pseudoaneurysm Formation ◽  
Free Wall Rupture ◽  
First Choice

Pseudoaneurysm of the left ventricle is rare and may occur as a result of transmural myocardial infarction. The course of rupture after acute myocardial infarction varies from a catastrophic event, with an acute tear leading to immediate death (acute rupture), or slow and incomplete tear leading to a late rupture (subacute rupture). Incomplete rupture may occur when the thrombus and haematoma together with the pericardium seal the rupture of the left ventricle and may develop into a pseudoaneurysm. Early diagnosis and treatment is essential in this condition. Two-dimensional color Doppler echocardiography is the first-choice method for most patients with suspected left ventricular pseudoaneurysm (LVP) and suggests left ventricular rupture in 85% to 90% of patients. We report the case of an 87-year-old woman presenting with symptoms and findings of myocardial infarction and left ventricular free wall rupture with a pseudoaneurysm formation diagnosed by echocardiography and confirmed on CT, MRI, and NM. She received only intense medical treatment, because she refused surgery with a favorable outcome. After 24-month followup, she is in NYHA functional class II. The survival of this patient is due to the contained pseudoaneurysm by dense pericardial adhesions, related to her previous coronary bypass surgery.

scholarly journals P262 Left ventricular pseudoaneurism due to a non-reperfused myocardial infarction: multi-modality cardiac imaging approach

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J A Fuentes Mendoza ◽  
O A Mondaca Garcia ◽  
N G Espinola Zavaleta
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Left Ventricular ◽  
Medical Attention ◽  
Inferior Wall ◽  
Risk Of Rupture ◽  
The Right

Abstract Introduction Cardiac rupture has been one of the most frequent fatal complications of acute myocardial infarction in cases series reported since 1977. However, in exceptional cases, the rupture of the left ventricle is contained by the pericardium and by fibrous tissue, forming a pseudoaneurysm, which is characterized by the absence of myocardial tissue in its wall and a relatively narrow neck between the ventricle and the ventricular chamber. Although there is no estimated time for rupture, it is well established that the risk of rupture is 30 to 40% and mortality up to 10%. Pseudoaneurysm is a rarer entity than rupture and is usually diagnosed incidentally by imaging methods in up to 48% of cases. The most frequent imaging method for their diagnosis is 2D echocardiography, followed by cardiac catheterization and finally cardiac magnetic resonance. The most frequent location of the pseudoaneurysm secondary to acute myocardial infarction is the inferior wall and the posterolateral wall of the left ventricle. Case Report We present 72-year-old male patient with a history of type 2 diabetes and smoking, who started symptoms with sudden onset of oppressive chest pain of 20 minutes duration, he did not attend medical attention. A month later, he went for a valuation with a first-contact physician, who referred him to our institution with a diagnosis of acute myocardial infarction without reperfusion therapy. At the initial assessment, it was found asymptomatic, in the resting ECG was found QS pattern with reversal of the T wave in leads DII, DIII and AVF. Cardiac SPECT was performed and showed an inferior transmural infarction, which extended as non-transmural to the inferolateral and inferoseptal walls, without ischemia. (Img. 1 and 2). A 2D and 3D transthoracic echocardiogram was performed, in which akinesia of the inferoseptal and apical walls was documented, as well as a saccular pseudoaneurysm of 5.6 X 4.7 cm in the basal and middle segment of the inferior and inferolateral walls, with an entrance orifice. 2.6 X 2.4 cm, as well as pericardial effusion. (Fig. 3 and 4). Coronary angiography was performed, demonstrating chronic total occlusion of the right coronary in its proximal segment and ostial obstruction of the left anterior descending. Cardiac magnetic resonance revealed inferior infarction and the presence of a pseudoaneurysm with lamellar thrombus was corroborated. (Img. 5). The patient was taken to surgical treatment, by reconstruction of the left ventricle with the Dor technique and CABG of the right coronary artery and the anterior descending artery. Receives medical treatment and a 1-month follow-up is in class I of the NYHA. Conclusion It is a clinical case about a potentially fatal complication of acute myocardial infarction, which in our case was detected incidentally since the patient had remained asymptomatic, there lies the importance of obtaining an accurate diagnosis in order to impact on the patient survival. Abstract P262 Figure. Pseudoaneurysm multi-modality images

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