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Blockade of endothelin-converting enzyme reduces pulmonary hypertension after cardiopulmonary bypass and circulatory arrest.

Publication ,  Journal Article
Kirshbom, PM; Tsui, SS; DiBernardo, LR; Meliones, JN; Schwinn, DA; Ungerleider, RM; Gaynor, JW
Published in: Surgery
August 1995

BACKGROUND: Pulmonary dysfunction associated with elevated pulmonary vascular resistance is a significant problem after cardiopulmonary bypass (CPB) and circulatory arrest. Mediators of the pulmonary hypertensive response to CPB have not been fully elucidated. The purpose of this study was to examine the contribution of the endothelium-derived vasoconstrictor endothelin-1 to postbypass pulmonary hypertension. METHODS: Twelve 1-month-old piglets were instrumented with left atrial and pulmonary artery (PA) micromanometers and a PA flow probe. Phosphoramidon (Phos, n = 6) pigs received a 30 mg/kg bolus of Phos, an endothelin converting enzyme inhibitor. Controls (n = 6) received saline solution. All animals were placed on CPB and underwent a 60-minute period of circulatory arrest. The indexed pulmonary vascular resistance (PVRI) was calculated at baseline for controls, both before and 10 minutes after drug infusion in the Phos group, and 15 minutes after separation from CPB in both groups. RESULTS: Pre-CPB, mean PA pressure, and PVRI were not different between the control and Phos groups (14.6 +/- 1.1 versus 14.5 +/- 1.1 mm Hg and 7322 +/- 1269 versus 7260 +/- 947 dyne/sec/kg/cm-5, respectively). After CPB mean PA pressure was significantly higher in control than Phos animals (32.1 +/- 1.1 versus 22.5 +/- 1.3 mm Hg, p = 0.0003). PVRI was also significantly higher in the controls (30896 +/- 4714 versus 14972 +/- 1710, dyne/sec/kg/cm-5, p = 0.02). CONCLUSIONS: Production of endothelin-1 during CPB and circulatory arrest is a mediator of postbypass pulmonary hypertension.

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Published In

Surgery

DOI

ISSN

0039-6060

Publication Date

August 1995

Volume

118

Issue

2

Start / End Page

440 / 444

Location

United States

Related Subject Headings

  • Vascular Resistance
  • Swine
  • Surgery
  • Pulmonary Circulation
  • Postoperative Complications
  • Metalloendopeptidases
  • Hypertension, Pulmonary
  • Hemodynamics
  • Heart Arrest, Induced
  • Glycopeptides
 

Citation

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Kirshbom, P. M., Tsui, S. S., DiBernardo, L. R., Meliones, J. N., Schwinn, D. A., Ungerleider, R. M., & Gaynor, J. W. (1995). Blockade of endothelin-converting enzyme reduces pulmonary hypertension after cardiopulmonary bypass and circulatory arrest. Surgery, 118(2), 440–444. https://doi.org/10.1016/s0039-6060(05)80356-3
Kirshbom, P. M., S. S. Tsui, L. R. DiBernardo, J. N. Meliones, D. A. Schwinn, R. M. Ungerleider, and J. W. Gaynor. “Blockade of endothelin-converting enzyme reduces pulmonary hypertension after cardiopulmonary bypass and circulatory arrest.Surgery 118, no. 2 (August 1995): 440–44. https://doi.org/10.1016/s0039-6060(05)80356-3.
Kirshbom PM, Tsui SS, DiBernardo LR, Meliones JN, Schwinn DA, Ungerleider RM, et al. Blockade of endothelin-converting enzyme reduces pulmonary hypertension after cardiopulmonary bypass and circulatory arrest. Surgery. 1995 Aug;118(2):440–4.
Kirshbom, P. M., et al. “Blockade of endothelin-converting enzyme reduces pulmonary hypertension after cardiopulmonary bypass and circulatory arrest.Surgery, vol. 118, no. 2, Aug. 1995, pp. 440–44. Pubmed, doi:10.1016/s0039-6060(05)80356-3.
Kirshbom PM, Tsui SS, DiBernardo LR, Meliones JN, Schwinn DA, Ungerleider RM, Gaynor JW. Blockade of endothelin-converting enzyme reduces pulmonary hypertension after cardiopulmonary bypass and circulatory arrest. Surgery. 1995 Aug;118(2):440–444.
Journal cover image

Published In

Surgery

DOI

ISSN

0039-6060

Publication Date

August 1995

Volume

118

Issue

2

Start / End Page

440 / 444

Location

United States

Related Subject Headings

  • Vascular Resistance
  • Swine
  • Surgery
  • Pulmonary Circulation
  • Postoperative Complications
  • Metalloendopeptidases
  • Hypertension, Pulmonary
  • Hemodynamics
  • Heart Arrest, Induced
  • Glycopeptides