Cardiac hemodynamics in PCI : effects of ischemia, reperfusion and mechanical support

The combined pressure-conductance catheter provides the opportunity to continuously assess systolic and diastolic LV function from pressure-volume loops in the catheterization laboratory, enabling accurate assessment of the timing and magnitude of the LV dynamic effects of therapeutic interventions. The purpose of this thesis is to investigate LV and coronary hemodynamic effects in the setting of PCI. In general, the thesis consists of four parts. The first part describes the effects of repeated episodes of acute myocardial ischemia on LV dynamic characteristics. The second part describes LV function and hemodynamic effects during primary PCI in STEMI patients. The third part concerns the evaluation of the safety, feasibility, and efficacy of a new LV unloading device for support in high-risk and primary PCI patients. The fourth part focuses on LV function recovery and its influence on the coronary microcirculation after primary PCI. This includes a discussion on the role of mechanical support in the setting of revascularization in acute myocardial infarction.