Abstract 189: The Effects of Fw-ii Axial Blood Pump on Cardiogenic Shock After Acute Myocardial Infarction in a Sheep Model
Background: High-risk percutaneous coronary interventions (PCI), refractory cardiogenic shock and in-lab cardiac arrest are all associated with a high mortality rate in patients with acute myocardial infarction (AMI). The extent to which the use of FW-II axial pump can improve outcomes in cardiogenic shock is not known.
Methods: In 12 adult male sheep, cardiogenic shock was induced by circumflex coronary artery ligation for 90 min, followed by 240 min of reperfusion. The animals were divided into two groups: control group had non-mechanic supportive care including dopamine, dobutamine and other drugs; FW-II axial pump group was supported with FW-II axial pump from 90 min after ischemia to 240 min after reperfusion. Hemodynamic efficacy (mean arterial pressure (MAP), cardiac index (CI), pulmonary artery pressure (PAP) and systemic vascular resistance (SVR)), left ventricular systolic / diastolic diameter, carotid artery blood flow velocity were measured at 3 specific conditions: preligation, postligation and before being euthanasiaed. Reperfusion area was detected by Evans blue, and apoptosis detection included TUNEL staining, caspase-3 activity, bax and bcl-2 relative expression in normal, borderline and infarcted myocardium.
Results: Animals in control group survived for an average of 24 ± 9.6 hours, and Animals in FW-II group survived 72 hours and were euthanasiaed. Compared with control group, MAP, CI, artery diastolic velocity, and oxygen delivery index (DO2I and VO2I) were significantly higher (P <0.05) in FW-II pump group; PAP and SVR was significantly lower than the control group (P <0.01); Infarct ratio (percentage of the infarct area relative to the area at infarct risk) was significantly reduced in FW-II pump group with a significant difference from control group (P < 0.001). Apoptotic index and bax expression of border zone myocardium were significantly lower in FW-II pump group (P<0.01). However, there were no difference between control group and FW-II pump group for apoptotic index and bax expression in normal and infarcted myocardium (P >0.05).
Conclusion: Short-term assistance of FW-II axial pump improved the survival of cardiogenic shock by increasing systemic organ perfusion and reducing myocardial apoptosis.
- © 2013 by American Heart Association, Inc.