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Effect of myocardial contractility on hemodynamic end points under concomitant microvascular disease in a porcine model

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Abstract

In this study, coronary diagnostic parameters, pressure drop coefficient (CDP: ratio of trans-stenotic pressure drop to distal dynamic pressure), and lesion flow coefficient (LFC: ratio of % area stenosis (%AS) to the CDP at throat region), were evaluated to distinguish levels of %AS under varying contractility conditions, in the presence of microvascular disease (MVD). In 10 pigs, %AS and MVD were created using angioplasty balloons and 90-μm microspheres, respectively. Simultaneous measurements of pressure drop, left ventricular pressure (p), and velocity were obtained. Contractility was calculated as (dp/dt)max, categorized into low contractility <900 mmHg/s and high contractility >900 mmHg/s, and in each group, compared between %AS <50 and >50 using analysis of variance. In the presence of MVD, between the %AS <50 and >50 groups, values of CDP (71 ± 1.4 and 121 ± 1.3) and LFC (0.10 ± 0.04 and 0.19 ± 0.04) were significantly different (P < 0.05), under low-contractility conditions. A similar %AS trend was observed under high-contractility conditions (CDP: 18 ± 1.4 and 91 ± 1.4; LFC: 0.08 ± 0.04 and 0.25 ± 0.04). Under MVD conditions, similar to fractional flow reserve, CDP and LFC were not influenced by contractility.

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Acknowledgments

This work is supported by a Grant-In-Aid from Great Rivers Affiliate, a National-Scientific Development Grant from the American Heart Association (Grant reference numbers 0755236B and 0335270N), and a Department of Veteran Affairs Merit Review Grant (I01CX000342). The authors would like to thank the members of the Transport in Engineering and Medicine lab, Dr Mahesh Krishnamoorthy, Mr Marwan Al-Rjoub, and Mr Bhaskar C. Konala for their help in data acquisition during the animal experiments. The authors deeply regret the sudden and untimely death of our collaborator Dr William Gottliebson. We will not only miss his collaboration and understanding of Engineering in Medicine, but more so his friendship.

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Authors and Affiliations

  1. School of Dynamic Systems, Department of Mechanical Engineering, University of Cincinnati, 593 Rhodes Hall, Cincinnati, OH, 45220, USA

    Srikara Viswanath Peelukhana, Kranthi K. Kolli & Rupak K. Banerjee

  2. Division of Cardiovascular Diseases, University of Cincinnati, Cincinnati, OH, 45221, USA

    Massoud A. Leesar, Mohamed A. Effat, Tarek A. Helmy & Imran Arif

  3. Department of Environmental Health, University of Cincinnati, Cincinnati, OH, 45221, USA

    Paul Succop

  4. Deaconess Hospital, Cincinnati, OH, 45221, USA

    Eric W. Schneeberger

  5. Veteran Affairs Medical Center, Cincinnati, OH, 45220, USA

    Srikara Viswanath Peelukhana, Kranthi K. Kolli, Massoud A. Leesar, Mohamed A. Effat, Tarek A. Helmy, Imran Arif & Rupak K. Banerjee

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  1. Srikara Viswanath Peelukhana
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Peelukhana, S.V., Kolli, K.K., Leesar, M.A. et al. Effect of myocardial contractility on hemodynamic end points under concomitant microvascular disease in a porcine model. Heart Vessels 29, 97–109 (2014). https://doi.org/10.1007/s00380-013-0355-9

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