Issn Print: 1058-2916

Publication Date: 2002/03/01


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ENERGETIC ADVANTAGES OF DEVICE-BASED LEFT VENTRICULAR SHAPE CHANGE

Masahiro Inoue; Patrick M McCarthy; Masami Takagaki; Yoshie Ochiai; Karuyoshi Doi; Cristiano Faber; Raymond Dessoffy; Michael W Kopcak; Kiyotaka Fukamachi

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Author Information: Biomedical Engineering, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH.

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Excerpt

We have reported that left ventricular (IV) shape change by Myosplint® reduced wall stress and improved LV function. The purpose of the study was to evaluate the effect of this shape change on myocardial energetics.
Methods: Heart failure was induced by rapid ventricular pacing at 230 bpm for 4 weeks in 7 dogs. In 3 Test dogs, the Myosplint was implanted in the LV to create a bilobular IV. Control dogs (n = 4) received a sham operation. Heart failure was maintained by rapid pacing at 190 bpm for an additional 4 weeks in all dogs. Myocardial oxygen consumption (MVO2) was measured using a circuit between the coronary sinus and the right atrium with a flow probe and blood sampling port. LV work (LVW) was also measured to calculate LV mechanical efficiency (ME).
Results: The MVO2 was significantly lower in the Test dogs than in the Control dogs. There ware no significant differences in LVW between the two groups as expected. As a result, the ME tended to be higher in the Test dogs than in the Control dogs. There were no differences in the heart rate or stroke volume. The left atrial pressure and LV end-diastolic pressure tended to be lower in the Test dogs.
Conclusion: Bilobular LV required less energy to perform the same amount of work. The results support our previous findings that the Myosplint reduced the LV wall stress and increased LV systolic performance without significantly affecting hemodynamics.
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