{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:16:36Z","timestamp":1791461796733,"version":"4.3.4"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Unloading the left ventricle and delaying reperfusion reduces infarct size in preclinical models of acute myocardial infarction. We hypothesized that a potential explanation for this effect is that left ventricular (\n                      <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n                      ) unloading before reperfusion increases collateral blood flow to ischemic myocardium.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Acute myocardial infarction was induced by balloon occlusion of the left anterior descending artery for 120\u00a0minutes in adult swine, followed by reperfusion for 180\u00a0minutes. After 90\u00a0minutes of occlusion, animals were assigned to 30\u00a0minutes of continued occlusion (n=6) or to 30\u00a0minutes of support with either an Impella\n                      <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>\n                      (n=4) or venoarterial extracorporeal membrane oxygenation (n=5) with persistent occlusion. The primary end point was measures of microcirculatory blood flow including the collateral flow index (\n                      <jats:styled-content style=\"fixed-case\">CFI<\/jats:styled-content>\n                      ) during left anterior descending artery occlusion as (P\n                      <jats:sub>w<\/jats:sub>\n                      \u2212\n                      <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n                      )\/(P\n                      <jats:sub>a<\/jats:sub>\n                      \u2212\n                      <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n                      ), where P\n                      <jats:sub>a<\/jats:sub>\n                      , P\n                      <jats:sub>w<\/jats:sub>\n                      , and\n                      <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n                      are aortic, coronary wedge, and right atrial pressure, respectively. Infarct size was quantified using triphenyltetrazolium chloride. Compared with continued occlusion, Impella, not venoarterial extracorporeal membrane oxygenation, reduced infarct size relative to the area at risk. Before reperfusion, Impella reduced\n                      <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n                      stroke work by 25% and increased the\n                      <jats:styled-content style=\"fixed-case\">CFI<\/jats:styled-content>\n                      by 75%, but venoarterial extracorporeal membrane oxygenation did not. Among all groups, the change in\n                      <jats:styled-content style=\"fixed-case\">CFI<\/jats:styled-content>\n                      between 90 and 120\u00a0minutes correlated inversely with the change in LV stroke work (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0.44,\n                      <jats:italic>P<\/jats:italic>\n                      =0.01) and infarct size (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0.41,\n                      <jats:italic>P<\/jats:italic>\n                      =0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We report for the first time that 30\u00a0minutes of\n                      <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n                      unloading during coronary occlusion increases the\n                      <jats:styled-content style=\"fixed-case\">CFI<\/jats:styled-content>\n                      , which correlates inversely with\n                      <jats:styled-content style=\"fixed-case\">LV stroke work<\/jats:styled-content>\n                      and infarct size. Venoarterial extracorporeal membrane oxygenation failed to increase the\n                      <jats:styled-content style=\"fixed-case\">CFI<\/jats:styled-content>\n                      and did not reduce infarct size.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.013586","type":"journal-article","created":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T10:22:22Z","timestamp":1573208542000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Left Ventricular Unloading Increases the Coronary Collateral Flow Index Before Reperfusion and Reduces Infarct Size in a Swine Model of Acute Myocardial Infarction"],"prefix":"10.1161","volume":"8","author":[{"given":"Natalia","family":"Briceno","sequence":"first","affiliation":[{"name":"British Heart Foundation Centre of Excellence and National Institute for Health Research Biomedical Research Centre School of Cardiovascular Medicine and Sciences King's College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva K.","family":"Annamalai","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Reyelt","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Crowley","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Qiao","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lija","family":"Swain","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Pedicini","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Foroutanjazi","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Jorde","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemini","family":"Yesodharan","sequence":"additional","affiliation":[{"name":"Molecular Cardiology Research Institute Surgical and Interventional Research Laboratories, and the CardioVascular Center Tufts Medical Center Boston 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