Myocardial protection of early extracorporeal membrane oxygenation (ECMO) support for acute myocardial infarction with cardiogenic shock in pigs.

The aim of this study was to explore myocardial protection of early extracorporeal membrane oxygenation (ECMO) support for acute myocardial infarction with cardiogenic shock in pigs. 24 male pigs (34.6 ± 1.3 kg) were randomly divided into three groups-control group, drug therapy group, and ECMO group. Myocardial infarction model was created in drug therapy group and ECMO group by ligating coronary artery. When cardiogenic shock occurred, drugs were given in drug therapy group and ECMO began to work in ECMO group. The pigs were killed 24 h after cardiogenic shock. Compared with in drug therapy group, left ventricular end-diastolic pressure in ECMO group decreased significantly 6 h after ligation (P < 0.05). At the end of the experiments, LV - dp/dt among three groups was significantly different, drug therapy group < ECMO group < control group. There was no difference in LV + dp/dt between drug therapy group and ECMO group. Compared with drug group, myocardial infarct size of ECMO group did not reduce significantly, but myocardial enzyme and troponin-I decreased significantly. Compared with drug therapy, ECMO improves left ventricular diastolic function, and may improve systolic function. ECMO cannot reduce myocardial infarct size without revascularization, but may have positive effects on ischemic areas by avoiding further injuring.

[Comparative analysis between cardiopulmonary exercise testing and echocardiography in patients of heart failure with normal ejection fraction].

OBJECTIVE: To assess the clinical and predictive value of cardiopulmonary exercise testing (CPET) used in heart failure with normal left ventricular ejection fraction (HFNEF). METHODS: A total of 49 HFNEF patients of (New York Heart Association) NYHA class II were randomly selected from September 2010 to July 2012. The parameters of CPET and ultrasonic cardiogram (UCG) were collected at Day 3 post-admission. Person's and partial correlations were used to perform to compare CPET and UCG. RESULTS: Pearson's correlation revealed that mitral peak velocity of early filling/early diastolic mitral annular velocity (E/E', 10.14 ± 2.05) was significantly correlated with peak oxygen uptake (VO2 peak, (24.15 ± 8.31) ml×kg⁻¹×min⁻¹, r = -0.287, P = 0.046), carbon dioxide production (VCO2, (1.63 ± 0.51) L/min, r = -0.429, P = 0.002), partial pressure of end-tidal carbon dioxide (PET CO2, (39.50 ± 7.77) mm Hg, r = -0.282, P = 0.050) and minute ventilation/carbon dioxide production (VE/VCO2, 31.69 ± 5.32, r = 0.411, P = 0.003). Early diastolic mitral annular velocity (E', (6.46 ± 1.60) cm/s) was relevant to VO2 peak (r = 0.351, P = 0.013), VCO(2) (r = 0.452, P = 0.001), PET CO2 (r = 0.310, P = 0.030), VE/VCO2 (r = -0.434, P = 0.002) and respiratory exchange ratio (RER, 1.18 ± 0.13, r = 0.350, P = 0.014). After adjustment, VCO2 was correlated with E/E' (r = -0.369, P = 0.019) and E' (r = 0.393, P = 0.010). VE/VCO2 was relevant to E/E' (r = 0.414, P = 0.006) and E' (r = -0.334, P = 0.031). CONCLUSION: For HFNFE patients, CPET has high values of assessment and prognosis.