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The Annals of Thoracic Surgery, Vol 57, 1605-1611, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

New method for mechanistic studies of cardiomyoplasty: three- dimensional MRI reconstructions

PW Cho, HR Levin, CC Moore, JE Tsitlik, ER McVeigh, TJ Gardner and MA Acker
Division of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.

The imaging modalities used to study the mechanism of cardiomyoplasty, such as echocardiography and radionuclide scintigraphy, are seriously limited by their two-dimensional format. Radiofrequency-pulse-tagged magnetic resonance imaging was used to generate three-dimensional reconstructions of the left ventricle throughout the cardiac cycle after cardiomyoplasty. In 2 dogs that had undergone conditioned, right anterior cardiomyoplasty, wrap stimulation with alternating heartbeats was found to produce marked translation of the left ventricle in the short-axis plane, rotation around the long axis, and displacement along the long axis with net long-axis compression; there was no augmentation of radial squeeze. The findings from this study suggest that any systolic augmentation produced by the right anterior wrap is due primarily to long-axis compression. Our study demonstrates a new, more accurate technique of assessing the mechanical effects of cardiomyoplasty in three dimensions, thus permitting a more rational optimization of wrap configurations, and emphasizes the perils of using standard two-dimensional imaging modalities in this setting of exaggerated three-dimensional motion.

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