Document Detail

Evidence of functional myocardial ischemia associated with myocardial dysfunction in brain-dead pigs.
MedLine Citation:
PMID:  11568055     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  104     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-24     Completed Date:  2001-10-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  I197-201     Citation Subset:  AIM; IM    
Laboratoire de Chirurgie Expérimentale, Faculté de Médecine de Nancy, Université Henri Poincaré, Nancy I, France.
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MeSH Terms
Adenosine / metabolism
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
Myocardial Ischemia / complications,  diagnosis*,  physiopathology*
Myocardium / metabolism
Oxygen / metabolism
Oxygen Consumption
Sympatholytics / pharmacology
Ventricular Function, Left / drug effects
Reg. No./Substance:
0/Sympatholytics; 36894-69-6/Labetalol; 50-21-5/Lactic Acid; 58-61-7/Adenosine; 7782-44-7/Oxygen

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