Document Detail


Modulation of coronary perfusion pressure can reverse cardiac dysfunction after brain death.
MedLine Citation:
PMID:  10086521     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Brain death results in a rapid decline in left ventricular function, which has clinical relevance for organ transplantation. The aim of the present study was to investigate coronary perfusion changes during brain death and their role in cardiac dysfunction. METHODS: In an in situ isolated canine heart model, brain death was induced by inflation of a subdural balloon catheter. The heart was perfused separately with the animal's own blood by a pressure-controlled roller pump that was coupled to the measured aortic pressure. Myocardial contractility was estimated by the slope of the end-systolic pressure-volume relation. RESULTS: Induction of brain death resulted in a transient hyperdynamic response, followed by a significant decrease in systemic vascular resistance, coronary blood flow, and the end-systolic pressure-volume relation (p<0.05). However, if coronary perfusion pressure was decoupled from aortic pressure and elevated to pre-brain death levels, coronary blood flow and the end-systolic pressure-volume relation were also restored to baseline levels. CONCLUSION: Severe impairment of coronary blood flow may contribute to decreased contractility after brain death that can be reversed by modulation of coronary perfusion pressure.
Authors:
G Szabó; T Hackert; C Sebening; C F Vahl; S Hagl
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  67     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-04-14     Completed Date:  1999-04-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  18-25; discussion 25-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, University of Heidelberg, Germany. dzsi@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain Death / physiopathology*
Dogs
Heart / physiology*
Hemodynamics
Myocardial Contraction
Regional Blood Flow
Ventricular Dysfunction, Left / etiology,  physiopathology*

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


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