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Magnitude of mitral valve closure plays a pivotal role in enhancing the forward blood flow during cardiac massage in dogs with ventricular fibrillation
Authors:Ai GOTO  Ryuichi KAMBAYASHI  Hiroko IZUMI-NAKASEKO  Yoshinori TAKEI  Shinichi KAWAI  Akio MATSUMOTO  Keith G. LURIE  Atsushi SUGIYAMA
Affiliation:1)Department of Pharmacology, Faculty of Medicine, Toho University, Tokyo, Japan;2)Department of Inflammation & Pain Control Research, Faculty of Medicine, Toho University, Tokyo, Japan;3)Department of Aging Pharmacology, Faculty of Medicine, Toho University, Tokyo, Japan;4)Department of Emergency Medicine, University of Minnesota Medical School, Minneapolis, USA
Abstract:Motion of mitral valve during cardiac massage was examined using beagle dogs with ventricular fibrillation (n=4). Active compression-decompression cardiac massage (ACD-CM) exhibited greater peak aortic pressure than standard cardiac massage (S-CM), reverse of which was true for peak pulmonary capillary wedge pressure in each animal. Accordingly, peak aortic pressure was greater than peak pulmonary capillary wedge pressure with ACD-CM, whereas its reverse was true with S-CM. Transesophageal echocardiography revealed that mitral valve was incompletely closed with S-CM with showing regurgitation. The valve was more effectively closed during ACD-CM. These results indicate that effective closure of mitral valve during cardiac massage may increase forward blood flow, supporting “cardiac pump theory” rather than “thoracic pump theory” as a principle in dogs.
Keywords:active decompression   cardiac massage   cardiac pump theory   mitral valve closure   transesophageal echocardiography
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