Performance of dynamic cardiomyoplasty related to the functional state of the heart.

Cardiomyoplasty (CMP) was performed with the left Latissimus dorsi in five beagles (group 1) with intact hearts and seven foxhounds (group 2) in whom the left ventricle was enlarged by 31 +/- 11.9% of cross-sectional area. Ventricular function curves were constructed at filling pressures ranging from 15-40 mmHg (group 2). Myocardial contraction patterns were investigated by epicardial 2-D echocardiography. Skeletal muscle contraction caused a significant increase in aortic pressure, dP/dt, stroke volume, work and performance in all animals. Function curves were shifted upward in a parallel manner. Echocardiography showed an increase of the LV cross-sectional delta area of 14.8% +/- 5.8% (group 1) and of 39.5% +/- 15.1%, and approximation of the edges of the wall defects (group 2). In conclusion, dynamic CMP as applied in this acute model, increased the performance of normal canine hearts and hence, a model of cardiac failure may not be a prerequisite for the investigation of certain technical aspects of CMP. In the failing heart, a parallel upward shift of myocardial function curves suggested increased performance of the heart/skeletal muscle complex over a wide range of filling pressures. However, the descending limb of the function curve with increasing filling pressures was observed despite skeletal muscle contraction. Hence, similar to other assist systems, the residual function of the heart may be of considerable importance in the overall performance of dynamic CMP.