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% reduc...

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Bibliographic Details
Published in:Annals of surgery 1975-06, Vol.181 (6), p.893-895
Main Authors: Proctor, H J, Starek, P J, Fry, J
Format: Article
Language:English
Subjects:
Animals
Aorta - physiology
Arthroplasty
Blood Pressure
Dogs
Endocardium - physiopathology
Heart Failure - therapy
Humans
Pressure
Shock, Hemorrhagic - physiopathology
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Summary: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.
ISSN:0003-4932
1528-1140
DOI:10.1097/00000658-197506000-00024