Mild hypothermia delays the development of stone heart from untreated sustained ventricular fibrillation - a cardiovascular magnetic resonance studyReport as inadecuate




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Journal of Cardiovascular Magnetic Resonance

, 13:17

First Online: 06 March 2011Received: 28 October 2010Accepted: 06 March 2011

Abstract

Background-Stone heart- resulting from ischemic contracture of the myocardium, precludes successful resuscitation from ventricular fibrillation VF. We hypothesized that mild hypothermia might slow the progression to stone heart.

MethodsFourteen swine 27 ± 1 kg were randomized to normothermia group I; n = 6 or hypothermia groups group II; n = 8. Mild hypothermia 34 ± 2°C was induced with ice packs prior to VF induction. The LV and right ventricular RV cross-sectional areas were followed by cardiovascular magnetic resonance until the development of stone heart. A commercial 1.5T GE Signa NV-CV-i scanner was used. Complete anatomic coverage of the heart was acquired using a steady-state free precession SSFP pulse sequence gated at baseline prior to VF onset. Un-gated SSFP images were obtained serially after VF induction. The ventricular endocardium was manually traced and LV and RV volumes were calculated at each time point.

ResultsIn group I, the LV was dilated compared to baseline at 5 minutes after VF and this remained for 20 minutes. Stone heart, arbitrarily defined as LV volume <1-3 of baseline at the onset of VF, occurred at 29 ± 3 minutes. In group II, there was less early dilation of the LV p < 0.05 and the development of stone heart was delayed to 52 ± 4 minutes after onset of VF P < 0.001.

ConclusionsIn this closed-chest swine model of prolonged untreated VF, hypothermia reduced the early LV dilatation and importantly, delayed the onset of stone heart thereby extending a known, morphologic limit of resuscitability.

Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-13-17 contains supplementary material, which is available to authorized users.

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Author: Vincent L Sorrell - Vijayasree Paleru - Maria I Altbach - Ronald W Hilwig - Karl B Kern - Mohamed Gaballa - Gordon A E

Source: https://link.springer.com/article/10.1186/1532-429X-13-17







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