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Cardiovascular Division, University of Virginia School of Medicine, Charlottesville, Virginia 22908
The controversy
regarding the mechanism(s) of left ventricular (LV) dysfunction in
chronic coronary artery disease is, in part, related to the lack of an
appropriate animal model for this condition. We have developed such a
model by placing Ameroid constrictors on proximal portions of coronary
arteries in dogs who were euthanized (mean of 6 wk) after
the development of severe global LV dysfunction noted on
two-dimensional echocardiography. The LV end-systolic size nearly
doubled (P < 0.001) over the
observation period, and the percent change in LV size from end diastole
to end systole decreased by >50% (P < 0.001). Regional dysfunction was noted in 23 of 24 myocardial beds
analyzed within regions showing no gross evidence of infarction. In 10 of these beds, severe dysfunction was noted without a decrease in
radiolabeled microsphere-derived myocardial blood flow (MBF). In 13 myocardial beds, decrease in function was associated with a decrease in
MBF (P < 0.001), with close coupling
noted between percent wall thickening and MBF. In the beds that
exhibited an ultimate decrease in MBF, the decrease in function
preceded the decrease in MBF. In conclusion, we describe chronic LV
dysfunction in a canine model of multivessel stenosis that closely
mimics chronic ischemic LV dysfunction in humans. Whereas
regional function is severely reduced in this model, MBF is varied in
different segments and at different times during the observation
period. These results provide new insights regarding flow-function
relations in chronic ischemic LV dysfunction.
stunned myocardium; hibernating myocardium; left ventricular function
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