Reciprocal strains in the normal and ischemic myocardium and their relation to the size of the ischemic region

Guillaume Jondeau, Mack L. Sullivan, Calvin Eng

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Abstract

Previous studies have reported "bulging" of the ischemic zone and reciprocal shortening of the normal zone during the isovolumetric contraction period. This study examines the interaction and relation of these reciprocal strains during the isovolumetric contraction period. Normal zone and ischemic zone segment length data were acquired at 1 ms intervals during acute ischemia in 10 open chest dogs. The relation of ischemic zone and normal zone segment length was inversely linear in the isovolumetric contraction period during steady state ischemia and during preload reduction (mean correlation coefficient 0.92). The slope derived from the regression analysis was the same as that determined from the first and last data points of the isovolumetric contraction period (correlation coefficient between the regression versus two-point slope 0.96). This slope was used to calculate the size of the ischemic area based on the hypothesis that the isovolumetric normal zone shortening quantitatively accounted for the ischemic zone bulging during the isovolumetric contraction period, with the percent risk region serving as a weighing factor. The calculated risk region correlated with the anatomic risk region (r = 0.83, p < 0.01; n = 9) and was independent of preload. During the isovolumetric contraction period, left ventricular short-axis diameter shortened approximately 0.2%; 80% of the ischemic zone lengthening occurred during this period. It is concluded that during ischemia 1) shortening of the normal myocardium is related quantitatively to ischemic myocardial lengthening (bulging) during the isovolumetric contraction period; 2) the reciprocal strain relation yields information on the size of the ischemic region; and 3) the short-axis left ventricular diameter does not increase as a consequence of ischemic zone lengthening, so that bulging as such does not appear to occur.

Original languageEnglish
Pages (from-to)1388-1396
Number of pages9
JournalJournal of the American College of Cardiology
Volume18
Issue number5
DOIs
StatePublished - 1 Nov 1991
Externally publishedYes

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