Document Detail


Cardiac outflow of endothelin, neuropeptide Y and noradrenaline in relation to hyperaemia in coronary sinus flow following electrical conversion of induced ventricular fibrillation in man.
MedLine Citation:
PMID:  8682028     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The implanted cardioverter defibrillator represents an alternative therapy for patients with drug-refractory malignant ventricular arrhythmias. Implantation and testing of the device requires that ventricular fibrillation be evoked and converted, thus providing a situation in which cardiovascular haemodynamics can be studied. In this study we have evaluated the effects of electrically induced ventricular fibrillation, followed by defibrillation, on coronary sinus blood flow and cardiac outflow of endothelin- and neuropeptide Y-like immunoreactivity (-LI) and of noradrenaline. Twelve patients were studied during implantation of a defibrillator. Ventricular fibrillation was induced and terminated after 17 +/- 1 s 5 +/- 1 times in each patient. In six patients coronary sinus blood flow was measured continuously. Plasma samples were obtained from four of these patients and another six patients, from the coronary sinus, radial artery and central vein before and during fibrillation and at two time points ( < 30 s and 5 min). Basal coronary sinus blood flow decreased to 38% at 14 +/- 2 s of ventricular fibrillation. Immediately following defibrillation there was a short-lasting increase in coronary sinus blood flow to 244% and a significant increase in the levels of neuropeptide Y-LI (146%) and noradrenaline (158%) in the coronary sinus while endothelin-LI remained unchanged (97%). Neither fibrillation nor defibrillation evoked any changes in the peripheral arterial and venous levels of endothelin-, neuropeptide Y-LI or noradrenaline. It is concluded that coronary sinus blood flow is markedly reduced during fibrillation and that restoration of normal impulse activity is followed by short-lasting hyperaemia. There was no evidence for effects on the vascular endothelium as assessed by endothelin levels.
Authors:
M Runsiö; M Rosenqvist; L Bergfeldt; A Owall; J M Lundberg; A Franco-Cereceda
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  16     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-08-16     Completed Date:  1996-08-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1925-9     Citation Subset:  IM    
Affiliation:
Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiac Pacing, Artificial
Coronary Circulation / physiology*
Defibrillators, Implantable*
Electrocardiography
Endothelins / blood*
Female
Hemodynamics / physiology
Humans
Hyperemia / physiopathology*
Male
Middle Aged
Myocardium / metabolism*
Neuropeptide Y / blood*
Norepinephrine / blood*
Reference Values
Ventricular Fibrillation / physiopathology*,  therapy
Chemical
Reg. No./Substance:
0/Endothelins; 0/Neuropeptide Y; 51-41-2/Norepinephrine
Comments/Corrections
Comment In:
Eur Heart J. 1995 Dec;16(12):1751-2   [PMID:  8681998 ]

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