| Evidence of functional myocardial ischemia associated with myocardial dysfunction in brain-dead pigs. | |
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MedLine Citation:
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PMID: 11568055 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac dysfunction after brain death has been documented, but its mechanisms remain unclear. Myocardial ischemia has been suggested as a possible cause. The aim of the present study was to investigate the existence of an imbalance between myocardial oxygen delivery and demand as a possible cause of myocardial dysfunction in brain-dead pigs. METHODS AND RESULTS: Interstitial myocardial lactate and adenosine concentrations were assessed with cardiac microdialysis in 2 groups of animals: brain-dead pigs (n=7) and brain-dead pigs treated with labetalol (10+/-3 mg/kg) (n=7). Heart rate (HR), left ventricular (LV) dP/dt(max), rate-pressure product (RPP), cardiac output (CO), and left anterior descending coronary artery blood flow (QLAD) were continuously monitored. Brain-dead pigs exhibited a transient significant increase in HR, LV dP/dt(max), RPP, and CO and a limited increase in QLAD. This resulted in functional myocardial ischemia attested to by the significantly increased adenosine and lactate microdialysate concentrations. In brain-dead pigs treated with labetalol, there was a moderate increase in HR, QLAD, and adenosine microdialysate concentrations; LV dP/dt(max), RPP, CO, and myocardial lactate concentrations remained stable, confirming the preservation of aerobic metabolism. CONCLUSIONS: Brain death was associated with an increase in myocardial interstitial adenosine and lactate concentrations, as well as with myocardial dysfunction; all were attenuated by labetalol, suggesting an imbalance between oxygen consumption and oxygen delivery as a possible cause of myocardial dysfunction after brain death. |
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Authors:
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C Seguin; Y Devaux; S Grosjean; E M Siaghy; P Mairose; F Zannad; N de Talancé; D Ungureanu-Longrois; P M Mertes |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 104 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2001 Sep |
Date Detail:
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Created Date: 2001-09-24 Completed Date: 2001-10-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: I197-201 Citation Subset: AIM; IM |
Affiliation:
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Laboratoire de Chirurgie Expérimentale, Faculté de Médecine de Nancy, Université Henri Poincaré, Nancy I, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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metabolism Animals Blood Flow Velocity / drug effects Blood Gas Analysis Blood Pressure Brain Death / physiopathology* Cardiac Output / drug effects Cardiomyopathies / complications, physiopathology* Coronary Circulation / drug effects Heart Rate / drug effects Labetalol / pharmacology Lactic Acid / metabolism Microdialysis Myocardial Ischemia / complications, diagnosis*, physiopathology* Myocardium / metabolism Oxygen / metabolism Oxygen Consumption Swine Sympatholytics / pharmacology Ventricular Function, Left / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Sympatholytics; 36894-69-6/Labetalol; 50-21-5/Lactic Acid; 58-61-7/Adenosine; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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