136 
CARDIAC MODELS 
Aortic Systolic Pressure 
<Rmducmd> 
U. Systolic Pressure 
Systolic Ejection Period 
<D9ermmamd> 
\ P.V./1. 
* ^lytM^nM Conlrsifflity 
LM Emptying 
<lmpro\^»d> 
LM WorK 
Coronary Vas. Resist 
<O0eraasmd> 
\ 
LV Volume 
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1 
Cardiac Output 
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Myocardial O2 
Consumption 
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Figure 17. — Hemodynamic and metabolic effects of counterpulsation produced by (a) low- 
ering aortic systolic pressure. 
16. DiETZMAN, R. H., Lyons, G. W., Bloch, J. H. and 
LlLLEHEi, R. C: Relation of Cardiac work to sur- 
vival in cardiogenic shock in dogs, J. A.M. A. 
199:825, 1967. 
17. Agress, C. M., Glassner, H. F., Binder, M. J., and 
Fields, J. : Hemodynamic measurements in experi- 
mental coronary shock: J. App. Physiol. 10:469, 
1957. 
18. JACOBEY, J. A., Taylor, W. J., Smith, G. T., 
GoRLiN, R. and Harken, D. E.: A new therapeutic 
approach to acute coronary occlusion. II opening of 
dormant coronary collateral channels by counter- 
pulsation, Amer. J. Cardiol. 11:218, 1963. 
19. GoLDFARB, D., CoNTi, C. P., Brown, B. G., and 
GOTT, V. L. : Treatment of severe cardiogenic shock 
by diastolic augmentation after ligation and 
division of the left circumflex coronary artery in 
dogs, J. Thoracic Cardiovasc. Surg. 51:783, 1966. 
20. KiSHi, K., Ota, Y., Hiratsuka, H., Akimoto, T., 
Yokoyama, M. and Sakakibara, S.: Mechanical 
assistance of coronary circulation in the ischemic 
heart with a newly devised technique, Ann. Thorac. 
Surg. 9:419, 1970. 
21. Merino, P. and Rosensweig, J.: Unpublished data. 
DISCUSSION 
Chairman La Farge : Thank you very much, 
Dr. Chatterjee. I hope that you all got the mes- 
sage : not only is this a beautiful presentation in 
terms of myocardial insufficiency, coronary in- 
sufficiency, but it very nicely demonstrates what 
happens with counterpulsation when used in 
almost any form. I think you explained the 
mechanism so well that it needs no further 
comment. 
Pitambar Somani, Abbot Laboratories, 
North Chicago, 111. : I have a basic reservation 
concerning dog models for any study of col- 
lateral circulation because, as we know well, 
the dog has preexisting collaterals which we do 
not find in the human heart or in other primates 
which have big hearts. Now one of the problems 
here is that you have preexisting collateral 
channels and you can easily demonstrate the 
improved collateral flow. I am very curious to 
find out if the same thing happens in the hu- 
man heart or in the other primate hearts. 
