| Plasma endothelin-1 level at the onset of ischemic ventricular fibrillation predicts resuscitation outcome. | |
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MedLine Citation:
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PMID: 19362407 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Endogenous vasopressors, including endothelin-1 (ET-1), have been shown to be elevated in patients following resuscitation from out-of-hospital cardiac arrest and are likely a physiologic response to global ischaemia. The importance of ET-1 in the setting of arrest and resuscitation has not been established. Prior work has demonstrated that ET-1 increases significantly after coronary occlusion. The purpose of this study was to assess changes in ET-1 following induction of ischaemia and VF. METHODS: VF was induced in 30 anesthetized and instrumented swine by balloon occlusion of the LAD. Blood was collected from the right atrium at baseline and at 5 min intervals following LAD occlusion until VF occurred. After 7 min of VF, resuscitation was attempted in accordance with guidelines. ET-1 and matrix metalloproteinase-9 (MMP-9), a measure of infarct size, were measured using ELISA. RESULTS: ET-1 and MMP-9 levels increased significantly from baseline within 20 min of occlusion of the LAD. Animals that could not be resuscitated had a higher ET-1 (p=0.031) at VF onset but similar ischaemia time (time to VF) and MMP-9, reflecting infarct size. An ET-1 level >4 pg/ml had a likelihood ratio of 4 for predicting resuscitation failure. CONCLUSIONS: Elevated levels of ET-1 during acute ischaemia predict resuscitation failure independent of the time to VF. This finding may be due to the known effect of ET-1 on coronary vascular resistance or ventricular compliance, resulting in early ischemic contracture. |
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Authors:
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Atman P Shah; James T Niemann; Scott Youngquist; Ted Heyming; John P Rosborough |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2009-04-10 |
Journal Detail:
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Title: Resuscitation Volume: 80 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-04 Completed Date: 2009-06-25 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 580-3 Citation Subset: IM |
Affiliation:
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Department of Medicine, Division of Cardiology, Harbor-UCLA Medical Center, Torrance, CA, United States. ashah@labiomed.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cardiopulmonary Resuscitation* Disease Models, Animal Endothelin-1 / blood* Male Matrix Metalloproteinase 9 / blood Myocardial Ischemia / blood*, etiology* Predictive Value of Tests Swine Time Factors Treatment Outcome Ventricular Fibrillation / blood*, complications, therapy* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL076671/HL/NHLBI NIH HHS; R01 HL076671-01A1/HL/NHLBI NIH HHS; R01 HL076671-02/HL/NHLBI NIH HHS; R01 HL076671-03/HL/NHLBI NIH HHS; R01 HL076671-04/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Endothelin-1; EC 3.4.24.35/Matrix Metalloproteinase 9 |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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