Dor procedure for dyskinetic anteroapical myocardial infarction fails to improve contractility in the border zone

Kay Sun, Zhihong Zhang, Takamaro Suzuki, Jonathan F. Wenk, Nielen Stander, Daniel R. Einstein, David A. Saloner, Arthur W. Wallace, Julius M. Guccione, Mark B. Ratcliffe

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Background: Endoventricular patch plasty (Dor) is used to reduce left ventricular volume after myocardial infarction and subsequent left ventricular remodeling. Methods and Results: End-diastolic and end-systolic pressure-volume and Starling relationships were measured, and magnetic resonance images with noninvasive tags were used to calculate 3-dimensional myocardial strain in 6 sheep 2 weeks before and 2 and 6 weeks after the Dor procedure. These experimental results were previously reported. The imaging data from 1 sheep were incomplete. Animal specific finite element models were created from the remaining 5 animals using magnetic resonance images and left ventricular pressure obtained at early diastolic filling. Finite element models were optimized with 3-dimensional strain and used to determine systolic material properties, Tmax,skinned-fiber, and diastolic and systolic stress in remote myocardium and border zone. Six weeks after the Dor procedure, end-diastolic and end-systolic stress in the border zone were substantially reduced. However, although there was a slight increase in Tmax,skinned-fiber in the border zone near the myocardial infarction at 6 weeks, the change was not significant. Conclusions: The Dor procedure decreases end-diastolic and end-systolic stress but fails to improve contractility in the infarct border zone. Future work should focus on measures that will enhance border zone function alone or in combination with surgical remodeling.

Original languageEnglish
Pages (from-to)233-239.e4
JournalJournal of Thoracic and Cardiovascular Surgery
Volume140
Issue number1
DOIs
StatePublished - Jul 2010

Bibliographical note

Funding Information:
This study was supported by National Institutes of Health grant R01-HL-77921 (to Dr Guccione), VA Merit Review (to Dr Wallace), and R01-HL-63348 (to Dr Ratcliffe).

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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