Document Detail


Myocardial fluid balance in acute hypertension.
MedLine Citation:
PMID:  9086448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We hypothesized that (1) acute arterial hypertension increases myocardial microvascular fluid filtration and (2) the combination of acute arterial hypertension and coronary sinus pressure elevation may increase myocardial microvascular filtration sufficiently to estimate the osmotic reflection coefficient of the myocardial exchange vessels. METHODS: In nine mechanically ventilated dogs we cannulated the prenodal major cardiac lymph trunk. With the use of central venous phenylephrine infusion, mean arterial pressure (MAP) was raised progressively to 120, 160, and 180 mm Hg. In five dogs we additionally raised coronary sinus pressure (CSP) to 20 and 40 mm Hg. At each manipulation of MAP and/or CSP, we measured indexes of myocardial lymphatic function and lymph-to-plasma concentration ratios for total protein (CL(TP)/CP(TP) and albumin (CL(alb)/CP(alb)). RESULTS: Myocardial lymph flow rate (QL; microL/min) increased exponentially (QL = 10.9.e0.014.(MAP) and myocardial lymph driving pressure (PL; mm Hg) increased linearly (PL = 2.30 + 0.20 + 0.20 . MAP) following increases, whereas CL(TP)/CP(TP) and CL(alb)/CP(alb) decreases from 0.67 +/- 0.07 (SD) to 0.56 +/- 0.10 and from 0.91 +/- 0.05 to 0.75 +/- 0.11, respectively. Adding CSP elevation increased QL up to 12 times control associated with further CL(TP)/C(TP) and CL(alb)/CP(alb) decreases to 0.49 +/- 0.05 and 0.59 +/- 0.02, respectively. CONCLUSIONS: We conclude that hypertensive arterial pressures are, at least in part, transmitted to the myocardial microvascular exchange vessels in the intact animal leading to increased microvascular fluid filtration. However, the combination of acute arterial hypertension and coronary sinus pressure elevation is not sufficient to produce filtration independence required for myocardial osmotic reflection coefficient determination.
Authors:
U Mehlhorn; K L Davis; G A Laine; H J Geissler; S J Allen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Microcirculation (New York, N.Y. : 1994)     Volume:  3     ISSN:  1073-9688     ISO Abbreviation:  Microcirculation     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-06-26     Completed Date:  1997-06-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9434935     Medline TA:  Microcirculation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  371-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Texas Medical School, Houston 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure / drug effects
Catheterization
Coronary Vessels / physiopathology*
Dogs
Edema
Heart / physiopathology*
Hemodynamics
Hypertension / physiopathology*
Lymph / physiology
Male
Microcirculation / physiology
Phenylephrine / pharmacology
Water-Electrolyte Balance / physiology*
Grant Support
ID/Acronym/Agency:
HL-36115/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
59-42-7/Phenylephrine

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


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