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Ann Thorac Surg 1997;64:404-408
© 1997 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Delayed Stimulation of the Latissimus Dorsi May Result in Disuse Atrophy

King Fahad Hospital, Riyadh, Saudi Arabia

Accepted for publication January 13, 1997.

Background. The latissimus dorsi is usually left unstimulated for 2 weeks after cardiomyoplasty to allow the muscle to recover from the loss of the collateral circulation. To determine whether the 2-week delay may cause muscle atrophy, we randomized 15 mongrel dogs to a control group or a disuse atrophy group.

Methods. The collateral circulation to the latissimus dorsi was ligated in all animals before cardiomyoplasty to reduce the risk of ischemic injury to the muscle during mobilization. Two weeks after collateral ligation, the atrophy group had the tendinous attachment of the latissimus dorsi severed and then 2 weeks later underwent cardiomyoplasty. The control group had a 2-week delay after collateral ligation followed by cardiomyoplasty. Biopsies were performed before collateral ligation and before cardiomyoplasty. After heart failure was induced, hemodynamic function was assessed during synchronized contraction of the latissimus dorsi by measuring the maximum systolic elastance, stroke volume, preload recruitable stroke work index, and diastolic compliance.

Results. Comparison of muscle morphology between the two groups demonstrated the presence of muscle atrophy in those animals that had been randomized to the atrophy protocol. During synchronized contraction of the latissimus dorsi, there was no significant increase in maximum systolic elastance in either group. However, both stroke volume and pulmonary recruitable stroke work index were significantly higher in the control animals during assisted beats. The left ventricle was less compliant in the atrophy group, suggesting that muscle atrophy had adversely affected diastolic function.

Conclusions. Delayed electrical stimulation of the latissimus dorsi may result in atrophy and loss of function.

Related Article

Invited Commentary

Stanley Salmons
Ann. Thorac. Surg. 1997 64: 408-409. [Extract] [Full Text]

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