Bio-energetic response of the heart to dopamine following brain death-related reduced myocardial workload:: A phosphorus-31 magnetic resonance spectroscopy study in the cat

被引:11
作者
Bruinsma, GJB [1 ]
Nederhoff, MGJ [1 ]
van de Kolk, CWA [1 ]
de Groot, MCH [1 ]
Slootweg, PJ [1 ]
Bredée, JJ [1 ]
Ruigrok, TJC [1 ]
Van Echteld, CJA [1 ]
机构
[1] Univ Utrecht Hosp, Heart Lung Inst, Utrecht, Netherlands
关键词
D O I
10.1016/S1053-2498(99)00089-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Long-term exposure of the donor heart to high dosages of dopamine in the treatment of brain death-related hemodynamic deterioration has been shown to reduce myocardial phosphocreatine (PCr) and adenosine triphosphate (ATP) in myocardial biopsy specimens and may preclude heart donation for transplantation. Short-term exposure to the acute catecholamine release during the onset of brain death has shown an unchanged PCr/ATP ratio using in vivo phosphorus-31 magnetic resonance spectroscopy (P-31 MRS). In this study P-31 MRS was used to evaluate in vivo myocardial energy metabolism during long-term dopamine treatment. Methods: Twelve cats were studied in a 4.7 Tesla magnet:for 360 minutes. At t = 0 minutes, brain death was induced (n = 6). At 210 minutes, when myocardial workload in the brain-death group was reduced significantly, dopamine was infused (n = 12) at 5 mu g/kg/min and its dose was consecutively doubled every 30 minutes and was withheld during the last 30 minutes of the experiment. Phosphorus-31 magnetic resonance spectra were obtained from the left ventricular wall during 5-minute time frames, and PCr/ATP ratios were calculated. The hearts were histologically examined. Results: Although significant changes in myocardial workload were observed after the induction of brain death and during support and withdrawal of dopamine in both groups, the initial PCr/ATP ratio of 2.00 +/- 0.12 and the contents of PCr and ATP did not vary significantly. Histologically identified sub-endocardial hemorrhage was observed in 3 of 6 of the brain-dead animals and in 1 of 6 of the control animals. Conclusions: High dosages of dopamine in the treatment of brain death-related reduced myocardial workload do not alter PCr/ATP ratios and the contents of PCr and ATP of the potential donor heart despite histologic damage.
引用
收藏
页码:1189 / 1197
页数:9
相关论文
共 28 条
[1]   Regulation of the cardiovascular system by non-adrenergic non-cholinergic nerves [J].
Ahluwalia, A ;
Cellek, S .
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, 1997, 6 (01) :74-79
[2]   Relationship between circulating levels of calcitonin gene-related peptide, nitric oxide metabolites and hemodynamic changes in human septic shock [J].
Arnalich, F ;
Hernanz, A ;
Jimenez, M ;
Lopez, J ;
Tato, E ;
Vazquez, JJ ;
Montiel, C .
REGULATORY PEPTIDES, 1996, 65 (02) :115-121
[3]   DOPAMINE TREATMENT OF LOCALLY PROCURED DONOR HEARTS - RELEVANCE ON POSTOPERATIVE CARDIAC HISTOLOGY AND FUNCTION [J].
BALLESTER, M ;
OBRADOR, D ;
ABADAL, L ;
CLADELLAS, M ;
BORDES, R ;
MANITO, N ;
PONSLLADO, G ;
PADRO, JM ;
ARIS, A ;
CARALPSRIERA, JM .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 1989, 22 (01) :37-42
[4]   MYOCARDIAL BETA-ADRENERGIC-RECEPTOR FUNCTION AND HIGH-ENERGY PHOSPHATES IN BRAIN DEATH-RELATED CARDIAC DYSFUNCTION [J].
BITTNER, HB ;
CHEN, EP ;
MILANO, CA ;
KENDALL, SWH ;
JENNINGS, RB ;
SABISTON, DC ;
VANTRIGT, P .
CIRCULATION, 1995, 92 (09) :472-478
[5]   Acute increase of myocardial workload, hemodynamic instability, and myocardial histological changes induced by brain death in the cat [J].
Bruinsma, GJBB ;
Nederhoff, MGJ ;
Geertman, HJ ;
vanHuffelen, AC ;
Slootweg, PJ ;
Ferrari, R ;
Galinanes, M ;
Hearse, DJ ;
Bredee, JJ ;
Ruigrok, TJC .
JOURNAL OF SURGICAL RESEARCH, 1997, 68 (01) :7-15
[6]  
Bruinsma GJBB, 1998, J HEART LUNG TRANSPL, V17, P984
[7]  
COOPER DKC, 1989, ANN ROY COLL SURG, V71, P261
[8]   BRAIN DEATH-INDUCED IMPAIRMENT OF CARDIAC CONTRACTILE PERFORMANCE CAN BE REVERSED BY EXPLANTATION AND MAY NOT PRECLUDE THE USE OF HEARTS FOR TRANSPLANTATION [J].
GALINANES, M ;
HEARSE, DJ .
CIRCULATION RESEARCH, 1992, 71 (05) :1213-1219
[9]   QUANTITATIVE P-31 NUCLEAR MAGNETIC-RESONANCE ANALYSIS OF METABOLITE CONCENTRATIONS IN LANGENDORFF-PERFUSED RABBIT HEARTS [J].
GARD, JK ;
KICHURA, GM ;
ACKERMAN, JJH ;
EISENBERG, JD ;
BILLADELLO, JJ ;
SOBEL, BE ;
GROSS, RW .
BIOPHYSICAL JOURNAL, 1985, 48 (05) :803-813
[10]   The effects of triiodothyronine on hemodynamic status and cardiac function in potential heart donors [J].
Goarin, JP ;
Cohen, S ;
Riou, B ;
Jacquens, Y ;
Guesde, R ;
LeBret, F ;
Aurengo, A ;
Coriat, P .
ANESTHESIA AND ANALGESIA, 1996, 83 (01) :41-47