Document Detail


Improved right heart function after myocardial preservation with 2,3-butanedione 2-monoxime in a porcine model of allogenic heart transplantation.
MedLine Citation:
PMID:  11782759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Right heart dysfunction is a major cause for early morbidity and mortality after heart transplantation. Experiments were designed to evaluate the influence of the calcium-desensitizing drug 2,3-butanedione 2-monoxime (BDM) on right heart function in a porcine model of heart transplantation. METHODS: Donor hearts of domestic pigs were arrested with BDM in Krebs solution (n = 7) and with BDM in Bretschneider's histidine-tryptophan-ketoglutarate (HTK) solution (n = 6). There were 2 control groups: University of Wisconsin (UW, n = 6) and HTK (n = 6). An isovolumic model was used in which the right ventricular volume was precisely controlled in vivo with an intracavitary high-compliance balloon. After 4 hours of ischemia, hearts were transplanted into recipients. After 1 and 2 hours of reperfusion, the right ventricular balloon volume was increased in 10-mL increments until right ventricular failure occurred and the developed pressures were recorded. RESULTS: Maximal right ventricular developed pressures were significantly different after 2 hours of reperfusion (UW: 35 +/- 13 mm Hg; HTK: 47 +/- 8 mm Hg; Krebs+BDM: 49 +/- 9 mm Hg; HTK+BDM: 50 +/- 6 mm Hg; P =.04). Hearts subjected to BDM could be loaded with a significantly increased volume after 1 hour and after 2 hours (UW: 57 +/- 10 mL vs HTK: 43 +/- 8 mL vs Krebs+BDM: 70 +/- 10 mL vs HTK+BDM: 67 +/- 15 mL; P =.002). Postischemic right ventricular enddiastolic compliance was significantly increased in groups treated with BDM after 1 hour (P =.02) and after 2 hours (P =.039). CONCLUSIONS: The drug BDM significantly improves right ventricular function in a heart transplantation model. The increase in volume load and developed right ventricular pressure achieved by BDM application would translate into a decreased risk of right ventricular failure after clinical transplantation.
Authors:
Gregor Warnecke; Benjamin Schulze; Christian Hagl; Axel Haverich; Uwe Klima
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  123     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-09     Completed Date:  2002-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adenosine
Allopurinol
Animals
Calcium / metabolism
Creatine Kinase / blood
Creatine Kinase, MB Form
Diacetyl / administration & dosage,  analogs & derivatives*,  pharmacology*
Glucose
Glutathione
Heart Transplantation / adverse effects,  physiology*
Insulin
Isoenzymes / blood
Isotonic Solutions
Lactic Acid / blood
Mannitol
Myocardium / metabolism
Organ Preservation*
Organ Preservation Solutions*
Potassium Chloride
Procaine
Raffinose
Swine
Ventricular Dysfunction, Right / etiology,  prevention & control
Ventricular Function, Right / drug effects*
Ventricular Pressure / drug effects
Chemical
Reg. No./Substance:
0/Bretschneider cardioplegic solution; 0/Isoenzymes; 0/Isotonic Solutions; 0/Krebs-Ringer solution; 0/Organ Preservation Solutions; 0/University of Wisconsin-lactobionate solution; 11061-68-0/Insulin; 315-30-0/Allopurinol; 431-03-8/Diacetyl; 50-21-5/Lactic Acid; 50-99-7/Glucose; 512-69-6/Raffinose; 57-71-6/diacetylmonoxime; 58-61-7/Adenosine; 59-46-1/Procaine; 69-65-8/Mannitol; 70-18-8/Glutathione; 7440-70-2/Calcium; 7447-40-7/Potassium Chloride; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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