Document Detail


The role of coronary perfusion changes in cardiac dysfunction associated with brain death.
MedLine Citation:
PMID:  9928854     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies described a hemodynamic instability in the potential organ donor which has clinical relevance for cardiac transplantation. The possible pathophysiological link between altered loading conditions, coronary perfusion, and cardiac function after brain death has not been investigated yet. Therefore this study was undertaken to investigate the role of coronary perfusion changes during brain death in cardiac dysfunction. METHODS: Dogs on cardiopulmonary bypass provided iso-volumetric left-ventricular (LV) contractions. By protocol, coronary perfusion pressure was kept at the level of mean aortic pressure. LV pressure, LV dP/dt, the slope of end-systolic pressure-volume relationship (Emax), coronary blood flow (CBF), and myocardial oxygen consumption (MVO2) were measured. Brain death was induced by a subdurally placed balloon-catheter. RESULTS: Induction of brain death led to a transient hyperdynamic response with a significant increase of aortic and LV pressure, dP/dt, Emax, CBF, and MVO2. Thereafter, aortic pressure and, parallelly, LV pressure, dP/dt, Emax, CBF, and MVO2 decreased significantly. However, if coronary perfusion pressure was decoupled from aortic pressure and elevated to pre-brain death level, CBF and myocardial contractility were restored to baseline level. Conclusion: The impairment of coronary blood flow may contribute to decreased contractility after brain death.
Authors:
G Szabó; C Sebening; T Hackert; L Hoffmann; S Melnitchuk; C F Vahl; S Hagl
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  46     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-04-05     Completed Date:  1999-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  339-43     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, University of Heidelberg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain Death / physiopathology*
Coronary Circulation / physiology*
Dogs
Female
Heart / physiopathology*
Male
Myocardial Contraction / physiology
Ventricular Function, Left / physiology

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


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