title: Comparison of myocardial loading between asynchronous pulsatile and nonpulsatile percutaneous extracorporeal life support.
abstract: We hypothesized that myocardial loading can be increased when extracorporeal pulse flow occurs during systole, and that this may adversely affect myocardial working conditions in heart failure patients supported by extracorporeal life support (ECLS). This study was designed to compare myocardial loading and myocardial oxygen consumption/supply balance between nonpulsatile ECLS and asynchronized pulsatile ECLS in a myocardial stunning model. Thirteen, 23-42 kg dogs were allotted to a nonpulsatile group and an asynchronous pulsatile group. Coronary sinus lactate level, mixed venous oxygen consumption (MvO2), and left anterior descending coronary artery flow were measured. The real-time pressure of the left ventricle and the ascending aorta was monitored, and the lowest left ventricular pressure and tension time index were calculated. Our results showed that the lactate level and the lowest left ventricular pressure were lower in the pulsatile group than in the nonpulsatile group at 30 minutes after ECLS was applicated (p < 0.05, respectively). Tension time index in the pulsatile ECLS group was substantially lower than in the nonpulsatile group. Left anterior descending coronary flow did not show significant difference between the two groups. In conclusion, asynchronous pulsatile ECLS may also be superior to nonpulsatile ECLS in myocardial volume unloading and oxygen consumption/supply balance.
authors: Department of Pediatrics, School of Medicine, Konkuk University, Seoul, Korea.
authors: Jeong Jin
authors: JJ
authors: Yu
authors: Ho Sung
authors: HS
authors: Son
authors: Choon Hak
authors: CH
authors: Lim
authors: Jung Joo
authors: JJ
authors: Lee
authors: Young Woo
authors: YW
authors: Park
authors: Keun
authors: K
authors: Her
authors: Yong Soon
authors: YS
authors: Won
authors: Kyung
authors: K
authors: Sun
authors: Jung Yun
authors: JY
authors: Choi
mesh_terms: D000818:Animals; D001775:Blood Circulation / Q000502:physiology*; D004285:Dogs; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006321:Heart / Q000502:physiology*; D017682:Myocardial Stunning / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption / Q000502:physiology; D010107:Oxygenators, Membrane; D011673:Pulsatile Flow / Q000502:physiology*