Regional expansion during myocardial ischemia predicts ventricular fibrillation and coronary reocclusion

Author:

Barrabés José A.1,Garcia-Dorado David1,González Miguel A.1,Ruiz-Meana Marisol1,Solares Julia2,Puigfel Yolanda1,Soler-Soler Jordi1

Affiliation:

1. Servicio de Cardiologı́a, Hospital General Universitari Vall d’Hebron, Barcelona 08035; and

2. Departamento de Anatomı́a Patológica, Hospital San Pedro de Alcántara, Cáceres, Spain 10003

Abstract

Primary ventricular fibrillation (VF) complicating acute myocardial infarction is associated with occluded infarction-related arteries. The relationship between VF during ischemia and spontaneous coronary reocclusion was analyzed in 48 anesthetized pigs submitted to 48 min of coronary ligation and 6 h of reflow. Reocclusion was associated with ischemic VF (6 of 11 animals with VF but only 6 of 37 without it had reocclusion) but not with reperfusion arrhythmias, the size of the ischemic area, the magnitude of electrocardiogram changes or contractile dysfunction during ischemia, or the severity of intimal injury at the occlusion site. The increase in end-diastolic length in the ischemic region during coronary occlusion was associated with ischemic VF (15 min after occlusion, end-diastolic length was 116 ± 2 and 111 ± 1% of baseline in animals with or without presenting subsequent VF, respectively) and was retained by multiple logistic regression analysis as the only independent predictor of ischemic VF and reocclusion. Thus ischemic VF is strongly associated with an increased rate of spontaneous coronary reocclusion during subsequent reperfusion. Acute expansion of ischemic myocardium appears as a prominent determinant of both ischemic VF and reocclusion.

Publisher

American Physiological Society

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Physiology

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