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

• Published in: Heart and vessels Vol. 30; no. 5; pp. 669 - 674
• Main Authors: Zhu, Gang-jie, Sun, Li-na, Li, Xing-hai, Wang, Ning-fu, Wu, Hong-hai, Yuan, Chen-xing, Li, Qiao-qiao, Xu, Peng, Ren, Ya-qi, Mao, Bao-gen
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.09.2015; Springer Nature B.V
• Subjects: Animals; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiovascular disease; Clinical outcomes; Disease Models, Animal; Extracorporeal Membrane Oxygenation - methods; Follow-Up Studies; Heart attacks; Hogs; Male; Medical procedures; Medicine; Medicine & Public Health; Myocardial Infarction - complications; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Myocardium - metabolism; Myocardium - pathology; Original Article; Shock, Cardiogenic - etiology; Shock, Cardiogenic - physiopathology; Shock, Cardiogenic - therapy; Stroke Volume - physiology; Swine; Swine, Miniature; Time Factors; Vascular Surgery; Ventricular Function, Left - physiology; Pigs; Myocardial protection; Acute myocardial infarction; Cardiogenic shock; Extracorporeal membrane oxygenation (ECMO)
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-014-0564-x

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 − d p /d t among three groups was significantly different, drug therapy group < ECMO group < control group. There was no difference in LV + d p /d t 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.