Investigation of Myocardial Stunning after Cardiopulmonary Resuscitation in Pigs

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Objective To investigate cardiac function and myocardial perfusion during 48 h after cardiopulmonary resuscitation (CPR), further to test myocardial stunning and seek indicators for long‐term survival after CPR. Methods After 4 min of untreated ventricular fibrillation, fifteen anesthetized pigs were studied at baseline and 2 h, 4 h, 24 h, and 48 h after restoration of spontaneous circulation (ROSC). Hemodynamic data, echocardiography and gated‐single photon emission computed tomography myocardial perfusion images were carried out. Results Mean arterial pressure (MAP), coronary perfusion pressure (CPP) and cardiac troponin I (CTNI) showed significant differences between eventual survival animals and non‐survival animals at 4 h after ROSC (109.2±10.7 mmHg vs. 94.8±12.3 mmHg, P=0.048; 100.8±6.9 mmHg vs. 84.4±12.6 mmHg, P=0.011; 1.60±0.13 ug/L vs. 1.75±0.10 ug/L, P=0.046). Mitral valve early‐to‐late diastolic peak velocity ratio, mitral valve deceleration time recovered 24 h; ejection faction and the summed rest score recovered 48 h after ROSC. Conclusion Cardiac systolic and early active relaxation dysfunctions were reversible within survival animals; cardiac stunning might be potentially adaptive and protective after CPR. The recovery of MAP, CPP, and CTNI could be the indicators for long‐term survival after CPR. Objective To investigate cardiac function and myocardial perfusion during 48 h after cardiopulmonary resuscitation (CPR), further to test myocardial stunning and seek indicators for long-term survival after CPR. Methods After 4 min of untreated ventricular fibrillation, fifteen anesthetized pigs were studied at baseline Results of arter arterial pressure (MAP), coronary artery pressure and echocardiography and gated-single photon emission computed tomography myocardial perfusion images were performed 2 h, 4 h, 24 h, and 48 h after corneal spontaneous circulation (ROSC) perfusion pressure (CPP) and cardiac troponin I (CTNI) showed significant differences between eventual survival animals and non-survival animals at 4 h after ROSC (109.2 ± 10.7 mmHg vs. 94.8 ± 12.3 mmHg, P = 0.048; 100.8 ± 6.9 mmHg vs . 84.4 ± 12.6 mmHg, P = 0.011; 1.60 ± 0.13 ug / L vs. 1.75 ± 0.10 ug / L, P = 0.046). Mitral valve early-to-late diastolic peak velocity ratio, mitral valve deceleration time recovered 24 h; ejection faction and the summed rest score scored 48 h after ROSC. Conclusion Cardiac systolic and early active relaxation dysfunctions were reversible within survival animals; cardiac stunning might be potentially adaptive and protective after CPR. The recovery of MAP, CPP, and CTNI could be the indicators for long-term survival after CPR.
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