Related Experiment Video
Updated: Jun 7, 2026
Real-time Pressure-volume Analysis of Acute Myocardial Infarction in Mice
Published on: July 2, 2018
The effect of repeated ischaemic periods on left ventricular dynamics during percutaneous coronary intervention
Maurice Remmelink1, Robbert J de Winter, José P S Henriques
1Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Insights
Online measurements show that balloon coronary occlusion during PCI causes phased left ventricular (LV) dysfunction. Repeated ischemia worsens LV systolic function more than ECG changes suggest.
Area of Science:
- Cardiology
- Interventional Cardiology
- Physiology
Background:
- Percutaneous coronary intervention (PCI) involves balloon angioplasty to open blocked coronary arteries.
- Understanding the immediate effects of ischemia and reperfusion on left ventricular (LV) function is crucial during PCI.
Purpose of the Study:
- To investigate the real-time dynamic changes in LV function during and after balloon coronary occlusions in patients undergoing PCI.
- To analyze the effects of consecutive occlusions and subsequent reperfusion on LV pressure-volume loops.
Main Methods:
- Utilized a pressure-conductance catheter to continuously measure LV pressure and volume (PV-loop) in 10 patients undergoing elective PCI.
- Performed prolonged balloon coronary occlusions and recorded LV dynamic effects and recovery post-reperfusion.
Main Results:
- Ischemia rapidly decreased diastolic function, followed by reduced contractile function (PV-loop shift, decreased dP/dtmax, ejection fraction).
- All parameters recovered within two minutes after reperfusion.
- A second occlusion induced faster, more significant LV dysfunction compared to the first, despite less ST-segment deviation on ECG.
Conclusions:
- Online LV pressure-volume analysis reveals a phased ischemic response: initial diastolic dysfunction followed by systolic dysfunction.
- Consecutive ischemia periods lead to more pronounced LV functional deterioration than indicated by ECG changes.
- LV pressure-volume dynamics provide a more sensitive assessment of ischemia during PCI than standard ECG monitoring.
Aims:
To study online left ventricular (LV) dynamic effects of transmural ischaemia and reperfusion during consecutive balloon coronary occlusions in the setting of percutaneous coronary intervention (PCI).
Methods And Results:
In 10 consecutive unselected patients with stable angina (seven males, mean age 62 ± 3 years) who underwent elective PCI, LV dynamics were continuously recorded using a pressure-conductance catheter to simultaneously measure pressure and volume (PV-loop). The effects of a prolonged balloon coronary occlusion (148 ± 19 s) and a second occlusion on various LV function parameters were studied, as well as recovery of these parameters after reperfusion. Ischaemia caused an immediate (<5 s) decrease in diastolic function, followed by a decrease in contractile function, indicated by a rightward shift of the PV-loop, and a decreased dP/dtmax and ejection fraction. All parameters recovered within two minutes after reperfusion. The second occlusion caused a more rapid and more pronounced decrease in systolic and global LV function, while the 12-lead ECG showed less ST-segment deviation.
Conclusions:
Online LV pressure-volume measurements during elective PCI show that prolonged balloon coronary occlusion causes a phased ischaemic response of diastolic dysfunction, and then systolic dysfunction with more pronounced deterioration during a consecutive ischaemic period, paradoxical to the ischaemic electrocardiographic signs.
