| Efficacy of oxygenated University of Wisconsin solution containing endothelin-A receptor antagonist in twenty-four-hour heart preservation. | |
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MedLine Citation:
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PMID: 8771503 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The University of Wisconsin solution has been proven to be effective for prolonged heart preservation. However, 24-hour heart preservation by simple cold immersion in University of Wisconsin solution has been disappointing. We have performed hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution for experimental prolonged heart preservation. However, the high potassium concentration of University of Wisconsin solution combined with prolonged ischemia has detrimental effects on endothelial function, which increases coronary tone during preservation and after reperfusion. The severe vasoconstriction and tissue edema result in damage to the coronary microcirculation. The purpose of this study was to determine whether hypothermic low-pressure continuous coronary perfusion technique with oxygenated University of Wisconsin solution containing a selective endothelin-A receptor antagonist (FR139317) would increase the effectiveness of the perfusion technique and improve postischemic cardiac function, both minimizing tissue edema and suppressing vasoconstriction. METHODS AND RESULTS: Preischemic and postischemic cardiac function of isolated rabbit hearts was evaluated with a Langendorff apparatus. The hearts were divided into three groups (n = 7 each): group I (hypothermic low-pressure continuous coronary perfusion with University of Wisconsin solution), group II (hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution), and group III (hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution containing 10 mg/L of FR139317). Preservation was performed for 24 hours. The initial perfusion pressure for continuous coronary perfusion was set at 5 mm Hg. Measurement of percentage of tissue water content and ultrastructural examination of the myocardium was then performed. In groups I, II, and III, the perfusion pressures at the end of the 24-hour preservation period increased from 5 mm Hg to 12.2 +/- 2.5, 8.1 +/- 1.3, and 5.4 +/- 0.8 mm Hg (p < 0.05), respectively. Percent recovery rate of cardiac output was 56.6 +/- 2.8, 82.3 +/- 8.2, and 93.3 +/- 6.0 (p < 0.05), respectively. And percent recovery rate of coronary flow was 55.5 +/- 8.1, 80.0 +/- 8.0, and 94.3 +/- 9.4 (p < 0.05), respectively. A significant inverse correlation was found between continuous coronary perfusion pressure at the end of preservation and the recovery rate of cardiac output (r = 0.85, p < 0.05). Tissue water content was significantly higher in group I than in groups II and III. These effects were inhibited by oxygenation of the University of Wisconsin solution (group II) and by the addition of the selective endothelin-A receptor antagonist (FR139317) (group III). Damage to coronary circulation was reduced by oxygenation and the addition of endothelin-A receptor antagonist during prolonged heart preservation. CONCLUSIONS: We concluded that hypothermic low-pressure continuous coronary perfusion technique with oxygenated UW solution containing endothelin-A receptor antagonist (FR139317) maintained coronary circulation by suppressing tissue edema and vasoconstriction during preservation, which improved postischemic functional recovery. |
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Authors:
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K Okada; C Yamashita; M Okada; M Okada |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 15 ISSN: 1053-2498 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 1996 May |
Date Detail:
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Created Date: 1996-10-24 Completed Date: 1996-10-24 Revised Date: 2004-12-03 |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 475-84 Citation Subset: IM |
Affiliation:
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Department of Surgery, Kobe University School of Medicine, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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administration & dosage,
therapeutic use Allopurinol / administration & dosage, therapeutic use Animals Azepines / administration & dosage, therapeutic use* Blood Pressure / drug effects Body Water / chemistry Cardiac Output / drug effects Cardioplegic Solutions / administration & dosage, therapeutic use* Coronary Circulation Cryopreservation Edema / prevention & control Glutathione / administration & dosage, therapeutic use Heart Transplantation* Hypothermia, Induced Indoles / administration & dosage, therapeutic use* Insulin / administration & dosage, therapeutic use Ischemia Microcirculation / drug effects Myocardial Contraction Myocardium / chemistry, ultrastructure Organ Preservation* Organ Preservation Solutions* Oxygen / administration & dosage, therapeutic use* Rabbits Raffinose / administration & dosage, therapeutic use Receptors, Endothelin / antagonists & inhibitors* Reperfusion Time Factors Vasoconstriction / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Azepines; 0/Cardioplegic Solutions; 0/Indoles; 0/Organ Preservation Solutions; 0/Receptors, Endothelin; 0/University of Wisconsin-lactobionate solution; 11061-68-0/Insulin; 142375-60-8/FR 139317; 315-30-0/Allopurinol; 512-69-6/Raffinose; 58-61-7/Adenosine; 70-18-8/Glutathione; 7782-44-7/Oxygen |
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