Summary
Left ventricular assist systems (LVAS) are a powerful means of cardiac assistance. The therapeutic effects of the LVAS in acute myocardial ischemia were evaluated from the standpoint of ischemic size, myocardial free fatty acid (FFA) metabolism and myocardial energy balance in acute animal experiments using mongrel dogs. In the study using magnetic resonance imaging (MRI) with gadolinium-DTPA, the LVAS decreased effectively both the ischemic area and degree of myocardial ischemia. 3-Beta-methyl-iodophenyl-pentadecanoic-acid (BMIPP)-imaging indicating tissue FFA metabolism was compared with thallium-201 chloride (TL) imaging to indicate tissue perfusion during LVAS assistance. LVAS pumping not only improved BMIPP and TL uptake in the ischemic myocardium, but also preserved the normal myocardium as evaluated by the FFA metabolism. High energy phosphate in myocardium and plasma catecholamine levels, which influenced cardiac energy metabolism, were evaluated under LVAS pumping. High energy phosphate levels showed no change in the normal myocardium by LVAS pumping. LVAS pumping reserved high energy phosphate concentrations in the ischemic myocardium and prevented the rise of catecholamine levels in profound heart failure.
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References
Takano H, Taenaka Y, Nakatani T, Akutsu T, Manabe H (1985) Successful treatment of profound left ventricular failure by automatic left ventricular assist system. World J Surg 9:78–88.
LeGal YM, Rideout SC (1983) Reduction of myocardial infarct size: a comparison of the effectiveness of intra-aortic balloon pumping and transapical left ventricular bypass. Trans Am Soc Artif Intern Organs 26:593–598.
Mickleborough LL, Rebeyka I, Wilson GL, Gray G, Desroiers A (1987) Comparison of left ventricular assist and intra-aortic balloon counterpulsation during early reperfusion after ischemic arrest of the heart. J Thorac Cardiovasc Surg 93:597–608.
Noda H, Nakatani T, Takano H, Fukuda S, Kinoshita M, Akutsu T (1985) The effect of LVAD on myocardial regional blood flow. Life Support System 4:35–40.
Grossi EA, Krieger KH, Cunningham JN, Laschinger JC, Weiss MR, Nathan IM, Hunter CE, Spencer FC (1986) Time course of effective interventional left heart assist for limitation of evolving myocardial infarction. J Thorac Cardiovasc Surg 91:624–629.
Nakatani T, Takano H, Taenaka Y, Umezu M, Tanaka T, Yutani C, Matsuda T, Iwata H, Noda H, Nakamura T, Takatani S, Seki J, Hayashi K, Akutsu T, Manabe H (1984) Therapeutic effect of left ventricular assist device on induced profound left ventricular failure — evaluation by left ventriculography. Trans Am Soc Artif Intern Organs 30:533–538.
Nakamura T, Hayashi K, Seki J, Nakatani T, Noda H, Fukuda S, Takano H, Akutsu T (1990) Effects of cardiac assist on the bulk and regional mechanics of the ischemic left ventricle in dogs. Artif Organs 14:57–68.
Nakatani T, Takano H, Noda H, Fukuda S, Nishimura T, Yamada Y, Kozuka T, Akutsu T (1986) Therapeutic effect of a left ventricular assist device on acute myocardial infarction evaluated by magnetic resonance imaging. Trans Am Soc Artif Intern Organs 32:201–206.
Noda H, Nishimura T, Kinoshita M, Taenaka Y, Kihara K, Sago M, Hayashi M, Takano H, Akutsu T (1988) Myocardial free fatty acid metabolism of the ischemic heart treated by left ventricular assist device. Trans Am Soc Artif Intern Organs 34:294–296.
Kinoshta M, Taenaka Y, Nakatani T, Noda H, Tatsumi E, Yagura A, Sekii H, Takano H, Akutsu T (1988) The effect of left ventricular assist device (LVAD) on the myocardial energy balance. Jpn J Artif Organs 17:919–922.
Knapp FF, Ambrose KR, Goodman MM (1986) New radioiodinated methyl- balanced fatty acids for cardiac studies. Eur J Nucl Med 12:539–544.
Dudezak R, Schmoliner R, Angelberger P, Knapp EF, Goodman MM (1986) Structurally modified fatty acids: clinical potential as tracers of metabolism. Eur J Nucl Med 12:45.
Otto CA, Brown LE, Scott AM (1985) Radioiodonated branched-chain fatty acids: substrates for beta oxidation? J Nucl Med 25:75–80.
van der Wall EE (1986) Myocardial imaging with radiolabeled free fatty acids: application and limitation. Eur J Nucl Med 12:511–515.
Watanabe F, Hashimoto T, Tagawa K (1985) Energy-independent protection of the oxidative phosphorylation capacity of mitochondria against anoxic damage by ATP and its nonmetabolizable analogs. J Biochem 97:1229–1234.
Higgins CB, Herfkens R, Lipton MJ, Sheldon P, Kaufman L, Crooks LE (1983) Nuclear magnetic resonance imaging of acute myocardial infarction in dogs: alterations in magnetic relaxation times. Am J Cardiol 52:184–188.
Wesbey GE, Higgins CB, Lauzer P, Botvinick E, Lipton MJ (1984) Imaging and characterization of acute myocardial infarction in vivo by gated magnetic resonace. Circulation 69:125–130.
Pflugfelder PW, Wisenberg G, Prato F, Carroll SE, Turner KL (1985) Early detection of canine myocardial infarction by magnetic resonace imaging in vivo. Circulation 71:587–594.
Nishimura T, Yamada Y, Hayashi M, Kozuka T, Nakatani T, Noda H, Takano H (1989) Determination of infarcted size of acute myocardial infarction in dogs by magnetic resonance imaging and gadolinium-DTPA: comparison with indium-Ill antimyosin imaging. Am J Physiol Imag 4:83–88.
Tsholakoff D, Higgins CB, Sechtem U, McNamara MT (1986) Occlusive and reperfused myocardial infarcts: effect of Gd-DTPA on ECG-gated MR imaging. Radiology 160:515–519.
McNamara MT, Tscholakoff D, Revel D, Soulen R, Schechtmann N, Botvinick E, Higgins CB (1986) Differentiation of reversible and irreversible myocardium injury by MR imaging with and without gadolinium-DTPA. Radiology 158:765–769.
Wesbey GE, Higgins CB, McNamara MT, Engelstad BL, Sievers R, Lipton MJ, Ehman RL, Lovin J, Brasch RC (1984) Effect of gadolinium-DTPA on the magnetic relaxation times of normal and infarcted myocardium. Radiology 153:165–169.
Reske SN, Schoen S, Schmitt W, Machulla HJ, Knopp R, Winkler C (1986) Effect of myocardial perfusion and metabolic interventions on cardiac kinetics of phenylpentadecanoic acid (IPPA) I 123. Eur J Nucl Med 12:527–531.
Wei CM, Imura M, Hattori R, Saito K, Fukuyama M, Yada I, Yuasa H, Kusagawa M (1986) The effect of left heart bypass on canine myocardial hemodynamics and metabolism. Jpn J Artif Organs 15:596–599.
Norris RM (1982) Metabolic sequelae of myocardial infarction. In: Myocardial infarction. Churchhill Livingstone, Edinburgh, pp 89–96.
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© 1991 Springer-Verlag Tokyo
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Nakatani, T., Takano, H., Noda, H., Kinoshita, M. (1991). Therapeutic Effects of the Left Ventricular Assist System on Myocardial Ischemia. In: Sasayama, S., Suga, H. (eds) Recent Progress in Failing Heart Syndrome. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67955-4_14
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DOI: https://doi.org/10.1007/978-4-431-67955-4_14
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