Intraaortic balloon counterpulsation: Its influence alone and combined with various pharmacological agents on regional myocardial blood flow during experimental acute coronary occlusion

G. K. Jett, S. K. Dengle, P. A. Barnett, M. R. Platt, J. T. Willerson, J. T. Watson, R. C. Eberhart

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

We investigated the separate and combined effects of pharmacological and intraaortic balloon pump (IABP) support on regional myocardial blood flow in an experimental model of acute myocardial ischemia. Chloralose-anesthetized dogs were ventilated with an oxygen-air mixture, and cardiac output, arterial pressure, and heart rate were held constant. Treatment was begun 20 minutes following permanent ligation of the left anterior descending coronary artery (LAD). We evaluated the following pharmacological interventions: 25% hypertonic mannitol, isosorbide dinitrate, methylprednisolone sodium succinate, and propranolol.We measured left ventricular hemodynamics and intramyocardial blood flow by the radioactive microsphere technique prior to treatment and at 15-minute intervals thereafter. Compared with control measurements 20 minutes following LAD ligation, collateral blood flow to ischemic myocardium tended to decrease with no treatment. Treatments with the four pharmacological interventions and with IABP alone produced no significant improvement in collateral blood flow to ischemic myocardium 15 minutes following treatment. In contrast, mannitol, isorbide dinitrate, and propranolol, each combined with IABP support, produced significant improvements in collateral flow within the same time periods. In nonischemic myocardium, combined pharmacological and IABP treatment did not enhance myocardial blood flow above that obtained with the pharmacological agents alone. The most effective combination of mechanisms for improving the ischemic region's myocardial blood flow appeared to be a reduction of extravascular coronary flow resistance coupled with a simultaneous increase in diastolic arterial pressure.

Original languageEnglish (US)
Pages (from-to)144-154
Number of pages11
JournalAnnals of Thoracic Surgery
Volume31
Issue number2
DOIs
StatePublished - 1981

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Counterpulsation
Coronary Occlusion
Regional Blood Flow
Pharmacology
Myocardium
Mannitol
Propranolol
Ligation
Arterial Pressure
Methylprednisolone Hemisuccinate
Isosorbide Dinitrate
Chloralose
Microspheres
Cardiac Output
Myocardial Ischemia
Coronary Vessels
Theoretical Models
Heart Rate
Hemodynamics
Air

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Intraaortic balloon counterpulsation : Its influence alone and combined with various pharmacological agents on regional myocardial blood flow during experimental acute coronary occlusion. / Jett, G. K.; Dengle, S. K.; Barnett, P. A.; Platt, M. R.; Willerson, J. T.; Watson, J. T.; Eberhart, R. C.

In: Annals of Thoracic Surgery, Vol. 31, No. 2, 1981, p. 144-154.

Research output: Contribution to journalArticle

Jett, G. K. ; Dengle, S. K. ; Barnett, P. A. ; Platt, M. R. ; Willerson, J. T. ; Watson, J. T. ; Eberhart, R. C. / Intraaortic balloon counterpulsation : Its influence alone and combined with various pharmacological agents on regional myocardial blood flow during experimental acute coronary occlusion. In: Annals of Thoracic Surgery. 1981 ; Vol. 31, No. 2. pp. 144-154.
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