B. Zane Atkins, MD, Scott C. Silvestry, MD, Ravi N. Samy, MD, Ashish S

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Calcitonin gene–related peptide enhances the recovery of contractile function in stunned myocardium B.Zane Atkins, MD, Scott C. Silvestry, MD, Ravi N. Samy, MD, Ashish S. Shah, MD, David C. Sabiston, MD, Donald D. Glower, MD The Journal of Thoracic and Cardiovascular Surgery Volume 119, Issue 6, Pages 1246-1254 (June 2000) DOI: 10.1067/mtc.2000.105457 Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Experimental preparation shows the pneumatic occluder secured around the LAD coronary artery (A), left atrial introducer catheter (B), intramyocardial ultrasonic dimension transducer pair in the ischemic (darkened area ) LAD coronary artery region (C), and ultrasonic dimension transducer pair in the LCX coronary artery distribution (D). Implanted pleural catheters and vena caval pneumatic occluders are not shown. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1246-1254DOI: (10.1067/mtc.2000.105457) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Representative raw data derived from the LAD coronary artery and the LCX myocardial regions are shown for one animal. Segment lengths and LV transmural pressure-segment length work loops in the respective distributions during control conditions, acute ischemia, and after 1.5, 3, 8, and 24 hours of reperfusion document the regional ischemia and gradual recovery within the LAD coronary artery region. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1246-1254DOI: (10.1067/mtc.2000.105457) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Mean heart rate (A) and LV end-diastolic pressure (B) for placebo, CGRP, and nitroglycerin (NTG ) during control conditions, acute ischemia, and 1.5, 3, 8, and 24 hours of reperfusion. NS , Not significant. Mean ejection pressure (C) and end-diastolic segment length (D) for placebo, CGRP, and nitroglycerin (NTG ) during control conditions, acute ischemia, and 1.5, 3, 8, and 24 hours of reperfusion. NS , Not significant. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1246-1254DOI: (10.1067/mtc.2000.105457) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 PRWA data (n = 6; mean ± SD) from the ischemic LAD coronary artery region after CGRP or nitroglycerin (NTG ) infusion compared with placebo. After reversible myocardial ischemia, contractile performance (PRWA) was significantly enhanced by CGRP over all reperfusion (P = .01) and after 1.5 hours of reperfusion (P = .04). Conversely, nitroglycerin did not significantly alter PRWA compared with placebo. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1246-1254DOI: (10.1067/mtc.2000.105457) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 PRWA data (n = 6; mean ± SD) expressed as percent baseline from the ischemic LAD coronary artery region after CGRP or nitroglycerin (NTG ) infusion compared with placebo. After reversible myocardial ischemia, PRWA was significantly enhanced by CGRP over all reperfusion (P = .01) and at each time in reperfusion (P < .05). Nitroglycerin did not significantly affect PRWA compared with placebo. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1246-1254DOI: (10.1067/mtc.2000.105457) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 6 PRWA data (mean ± SD) in the ischemic LAD coronary artery region for all 8 animals that received CGRP infusion compared with placebo. After reversible ischemia, contractile performance (PRWA) was significantly enhanced by CGRP over all reperfusion (P = .005) and at each time in reperfusion (P < .05). The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1246-1254DOI: (10.1067/mtc.2000.105457) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 7 PRWA data (mean ± SD) from the nonischemic LCX coronary artery region after CGRP infusion compared with placebo. PRWA was increased during CGRP infusion; however, PRWA for CGRP and placebo were similar during the remainder of recovery. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1246-1254DOI: (10.1067/mtc.2000.105457) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions