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The Annals of Thoracic Surgery, Vol 57, 1605-1611, Copyright © 1994 by The Society of Thoracic Surgeons
PW Cho, HR Levin, CC Moore, JE Tsitlik, ER McVeigh, TJ Gardner and MA Acker
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.
ARTICLES
New method for mechanistic studies of cardiomyoplasty: three- dimensional MRI reconstructions
Division of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
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