An investigation of endocardial viability ratio in myocardial failure following prolonged hemorrhagic shock.
Previous work has documented prolonged survival in dogs subjected to hemorrhagic shock when intra-aortic balloon counter-pulsation (IABC) was instituted in the presence of a 25%-50% reduction in the slope of the left ventricular function curve. Little benefit was noted in the presence of a 75% reduction in slope. In this study, myocardial failure was created in ten dogs by varying periods of hemorrhagic shock. The Endocardial Viability Ratio (EVR) was selected as a method of assessing coronary subendocardial perfusion and was evaluated as a potential method of selecting patients with myocardial failure most likely to benefit from IABC by noting the correlation between EVR and the slope of a simultaneously constructed left ventricular function curve. A significant correlation (r equals .72, p smaller than .001) was noted. The data suggest that a major factor in myocardial failure following hemorrhagic shock is deficient subendocardial coronary perfusion. Variability in data points would make selection of patients on the basis of EVR difficult.
D000818:Animals; D001011:Aorta / Q000502:physiology; D001178:Arthroplasty; D001794:Blood Pressure; D004285:Dogs; D004699:Endocardium / Q000503:physiopathology*; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D011312:Pressure; D012771:Shock, Hemorrhagic / Q000503:physiopathology*