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Myocardial beta-adrenergic receptor function and high-energy phosphates in brain death--related cardiac dysfunction.

Publication ,  Journal Article
Bittner, HB; Chen, EP; Milano, CA; Kendall, SW; Jennings, RB; Sabiston, DC; Van Trigt, P
Published in: Circulation
November 1, 1995

BACKGROUND: Cardiac failure remains an important problem after heart transplantation and may be associated with events that occur during brain death (BD) before transplantation. In this study, cardiac function is studied after BD, and biochemical evaluation of myocardial high-energy phosphates and the beta-adrenergic receptor system is presented. METHODS AND RESULTS: The hearts of 17 mongrel dogs (23 to 31 kg) were instrumented with flow probes, micromanometers, and ultrasonic dimension transducers to measure ventricular pressure and volume relationships. In a validated canine BD model, systolic right and left ventricular (RV/LV) function was analyzed by load-insensitive measurements during caval occlusion (preload-recruitable stroke work, PRSW). The beta-adrenergic receptor (BAR) density, adenylate cyclase (AC) activity, and myocardial ATP and creatine phosphate (CP) were measured before and 6 to 7 hours after BD. Results are expressed as mean +/- SEM (*P < .05 versus baseline, paired two-tailed Student's t test). Myocardial function deteriorated significantly from baseline PRSW (RV, 22 +/- 1 erg x 10(3); LV, 75 +/- 4 erg x 10(3)) by 37 +/- 10% for the RV (P < .001) and 22 +/- 7% for the LV (P < .001). BAR density increased from 282 +/- 42 to 568 +/- 173 fmol/mg for the RV and from 291 +/- 64 to 353 +/- 56 fmol/mg for the LV. Isoproterenol-stimulated AC activity was also significantly enhanced after BD. ATP and CP, however, remained unchanged after BD compared with baseline values before BD. CONCLUSIONS: BD causes significant systolic biventricular dysfunction. The loss of ventricular function after BD was more prominent in the right ventricle and may contribute to early postoperative RV failure in the recipient. These injuries occurred despite BAR system upregulation after BD. Global myocardial ischemia is unlikely, since ATP and CP remained normal before and after BD.

Duke Scholars

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

November 1, 1995

Volume

92

Issue

9 Suppl

Start / End Page

II472 / II478

Location

United States

Related Subject Headings

  • Ventricular Function
  • Ventricular Dysfunction, Right
  • Ventricular Dysfunction, Left
  • Receptors, Adrenergic, beta
  • Phosphocreatine
  • Myocardium
  • Male
  • Hemodynamics
  • Heart
  • Energy Metabolism
 

Citation

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Bittner, H. B., Chen, E. P., Milano, C. A., Kendall, S. W., Jennings, R. B., Sabiston, D. C., & Van Trigt, P. (1995). Myocardial beta-adrenergic receptor function and high-energy phosphates in brain death--related cardiac dysfunction. Circulation, 92(9 Suppl), II472–II478. https://doi.org/10.1161/01.cir.92.9.472
Bittner, H. B., E. P. Chen, C. A. Milano, S. W. Kendall, R. B. Jennings, D. C. Sabiston, and P. Van Trigt. “Myocardial beta-adrenergic receptor function and high-energy phosphates in brain death--related cardiac dysfunction.Circulation 92, no. 9 Suppl (November 1, 1995): II472–78. https://doi.org/10.1161/01.cir.92.9.472.
Bittner HB, Chen EP, Milano CA, Kendall SW, Jennings RB, Sabiston DC, et al. Myocardial beta-adrenergic receptor function and high-energy phosphates in brain death--related cardiac dysfunction. Circulation. 1995 Nov 1;92(9 Suppl):II472–8.
Bittner, H. B., et al. “Myocardial beta-adrenergic receptor function and high-energy phosphates in brain death--related cardiac dysfunction.Circulation, vol. 92, no. 9 Suppl, Nov. 1995, pp. II472–78. Pubmed, doi:10.1161/01.cir.92.9.472.
Bittner HB, Chen EP, Milano CA, Kendall SW, Jennings RB, Sabiston DC, Van Trigt P. Myocardial beta-adrenergic receptor function and high-energy phosphates in brain death--related cardiac dysfunction. Circulation. 1995 Nov 1;92(9 Suppl):II472–II478.

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

November 1, 1995

Volume

92

Issue

9 Suppl

Start / End Page

II472 / II478

Location

United States

Related Subject Headings

  • Ventricular Function
  • Ventricular Dysfunction, Right
  • Ventricular Dysfunction, Left
  • Receptors, Adrenergic, beta
  • Phosphocreatine
  • Myocardium
  • Male
  • Hemodynamics
  • Heart
  • Energy Metabolism