Document Detail

Differential subendocardial perfusion and injury during the course of gram-negative endotoxemia.
MedLine Citation:
PMID:  7032258     Owner:  NLM     Status:  MEDLINE    
This laboratory has been investigating the concept that a progressive state of global myocardial ischemia is a major precipitating factor in the etiology of the myocardial failure in endotoxin shock. To further test this hypothesis, endotoxin shock (E coli, B5, 4 mg/kg) was induced in the canine model, and coronary and systemic hemodynamics were monitored for five hours. Coronary flow decreased from 90.05 +/- 28 ml/min/100 gm left ventricle (n = 7) to 45 +/- 10 at five hours (n = 6), with two experimental deaths between four and five hours. Coronary vascular resistance increased from 61.82 +/- 2.5 X 10(3) dynes . sec . cm-5 to 128.6 X 10(3) +/- 18 X 10(3) dynes . sec . cm-5. Sham controls (n = 7) demonstrated no significant difference in either flow or resistance between zero to five hours. Gross examination of the shocked hearts demonstrated patchy to diffuse subendocardial hemorrhage not present in the sham preparations. Thioflavin S injection (4%, 1 ml/kg) demonstrated uniform perfusion under UV light (360 nm) in the sham preparations and marked nonuniform perfusion in the subendocardial surface of the shocked hearts. Histologic examination demonstrated diffuse intramyocardial hemorrhage, more marked in the subendocardium than the midmyocardium. Electron micrographs demonstrated swelling and distortion of the subendocardial sarcoplasmic reticulum and T-tubules and dehiscence of the myofibrils. It is concluded that the decrease in flow and concomitant increase in intramyocardial resistance progresses to a state of global ischemia and ischemic necrosis at the more vulnerable subendocardial surface.
W M Kleinman; S M Krause; M L Hess
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Advances in shock research     Volume:  4     ISSN:  0195-878X     ISO Abbreviation:  Adv Shock Res     Publication Date:  1980  
Date Detail:
Created Date:  1982-02-12     Completed Date:  1982-02-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7908298     Medline TA:  Adv Shock Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  139-52     Citation Subset:  IM    
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MeSH Terms
Coronary Circulation*
Endocardium / pathology*
Escherichia coli
Papillary Muscles / ultrastructure
Pericardium / ultrastructure
Shock, Septic / pathology,  physiopathology*
Vascular Resistance
Reg. No./Substance:

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