New hopes for dynamic cardiomyoplasty from use of Doppler flow wire in evaluation of demand stimulation.
BACKGROUND
There are no data regarding real cardiac assistance in demand dynamic cardiomyoplasty (DDCMP). A test of the use of Doppler flow wire is presented to demonstrate cardiac assistance in DDCMP.


METHODS
Comparative study in hospitalized care. A peripheral Flex Doppler flow wire of 0.018 inch was advanced through a 4F introducer femoral arterial in seven DDCMP patients (age=57.1+/-6.2 years; NYHA= 1.4+/-0.5). A short period of 10 sec with stimulator off and a following period of 15 sec with clinical stimulation were recorded. We measured the maximum peak aortic flow velocity (MPAV) in all beats. Latissimus dorsi (LD) mechanogram was simultaneously recorded.


RESULTS
Statistical analysis showed an increase not only in MPAV in assisted period versus rest, but also in assisted beats versus unassisted (8.42+/-6.98% and 7.55+/-3.07%).


CONCLUSIONS
Intravascular Doppler proved real systolic assistance in DDCMP; in DDCMP systolic assistance is correlated to the LD wrap speed of contraction, suggesting that demand stimulation could be the most effective protocol in dynamic cardiomyoplasty.
Rigatelli
G L
GL
Division of Cardiology, Interventional Cardiology LAB and Cardiomyoplasty Project Unit, Legnago General Hospital, Verona, Italy. jackyheart@katamail.com
Carraro
U
U
Barbiero
M
M
Zanchetta
M
M
Rigatelli
G
G
D000161:Acoustic Stimulation; D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D018421:Cardiomyoplasty; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013599:Systole / Q000502:physiology; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional