ArticleJournal of the American College of Cardiology2018
Acute Left Ventricular Unloading Reduces Atrial Stretch and Inhibits Atrial Arrhythmias.
Article in Journal of the American College of Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 35 citations in OpenAlex.
- Obstructive Sleep Apnoea and Atrial Fibrillation: Current Evidence and Emerging Research Directions.Reviews in cardiovascular medicine · 2026Review
- From Defense to Disease: NADPH Oxidase in Cellular Function and Dysregulation.Journal of immunology research · 2026Review
- NADPH oxidases: redox regulation of cell homeostasis and disease.Physiological reviews · 2025Review
- Mechanical Circulatory Support Reduces Directly Recorded Cardiac Sympathetic Nerve Activity in Ovine Acute Myocardial Infarction.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
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- Animal Models for Mechanical Circulatory Support: A Research Review.Reviews in cardiovascular medicine · 2024Review
- Ambulatory 7-day mechanical circulatory support in sheep model of pulmonary hypertension and right heart failure.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Incidence of Acute Kidney Injury Is Lower in High-Risk Patients Undergoing Percutaneous Coronary Intervention Supported with Impella Compared to ECMO.Journal of cardiovascular translational research · 2022Article
- Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes.The international journal of cardiovascular imaging · 2021Article
- New Advances in Monitoring Cardiac Output in Circulatory Mechanical Assistance Devices. A Validation Study in a Porcine Model.Frontiers in physiology · 2021Article
- Percutaneous left ventricular assist support is associated with less pulmonary congestion and lower rate of pneumonia in patients with cardiogenic shock.Open heart · 2020Observational
- Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with MitraclipAnnals of translational medicine · 2020Article
- Early cardiac unloading with ImpellaCP™ in acute myocardial infarction with ventricular septal defect.ESC heart failure · 2020Article
- Ranolazine-Mediated Attenuation of Mechanoelectric Feedback in Atrial Myocyte Monolayers.Frontiers in physiology · 2020Article
- Characterization of a porcine model of atrial arrhythmogenicity in the context of ischaemic heart failure.PloS one · 2020Article
- Beyond Reperfusion: Acute Ventricular Unloading and Cardioprotection During Myocardial Infarction.Journal of cardiovascular translational research · 2019Review
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9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundLeft atrium (LA) physiology is influenced by changes in left ventricular (LV) performance and load.
objectivesThe purpose of this study was to define the effect of acute changes in LV loading conditions on LA physiology in subacute myocardial infarction (MI).
methodsMI was percutaneously induced in 19 Yorkshire pigs. One to 2 weeks after MI, 14 pigs underwent acute LV unloading using a percutaneous LV assist device, Impella. The remaining 5 pigs underwent acute LV loading by percutaneous induction of aortic regurgitation. A pressure-volume catheter was inserted into the LA using a percutaneous transseptal approach, and LA pressure-volume loops were continuously monitored. Atrial arrhythmia inducibility was examined by burst-pacing of the right atrium. Nicotinamide adenine dinucleotide phosphate oxidase (NOX) levels and ryanodine receptor phosphorylation were examined in LA tissues to study the potential effect of stretch-dependent oxidative stress.
resultsMI resulted in reduced LV ejection fraction and increased LV end-diastolic pressure with concomitant increase in LA pressure and volumes. Acute LV unloading resulted in a reduction of LV end-diastolic pressure, which led to proportional decreases in mean LA pressure and maximum LA volume. LA pressure-volume loops exhibited a pump flow-dependent, left-downward shift. This was associated with reduced LA passive stiffness, suggesting the alleviation of the LA stretch that was present after MI. Prior to acute unloading of the LV, 71% of the pigs were arrhythmia-inducible; LV unloading reduced this to 29% (p = 0.02). Time to spontaneous termination of atrial arrhythmias was decreased from median 55 s (range 5 to 300 s) to 3 s (range 0 to 59 s). In contrast, acute LV loading with aortic regurgitation increased LA pressure without a significant effect on arrhythmogenicity. Molecular analysis of LA tissue revealed that NOX2 expression was increased after MI, whereas acute LV unloading reduced NOX2 levels and diminished ryanodine receptor phosphorylation.
conclusionsAcute LV unloading relieves LA stretch and reduces atrial arrhythmogenicity in subacute MI.
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