THE JAUNDICED HEART - EVIDENCE OF BLUNTED RESPONSE TO POSITIVE INOTROPIC STIMULATION

被引：34

作者：

LUMLERTGUL, D

BOONYAPRAPA, S

BUNNACHAK, D

THANACHAIKUN, N

PRAISONTARANGKUL, OA

PHORNPHUTKUL, K

KEOPLUNG, M

机构：

[1] Divisions of Nephrology, Faculty of Medicine, Chiang Mai University, Chiang Mai

[2] Divisions of Cardiology, Faculty of Medicine, Chiang Mai University, Chiang Mai

[3] Divisions of Gastroenterology Faculty of Medicine, Chiang Mai University, Chiang Mai

[4] Department of Medicine, Radiology Faculty of Medicine, Chiang Mai University, Chiang Mai

[5] Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai

来源：

RENAL FAILURE | 1991年 / 13卷 / 01期

关键词：

CARDIOSCINTIGRAPHY; INOTROPIC STIMULATION; JAUNDICE; LEFT VENTRICULAR EJECTION FRACTION; RENAL FAILURE;

D O I：

10.3109/08860229109022141

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Obstructive jaundice has been known to cause severe hemodynamic disturbance. The present study was therefore designed to assess the cardiac involvement in jaundiced patients. The multiple-gated blood pool cardioscintigraphic studies were done in 9 jaundiced patients who had either cholestatic or obstructive jaundice (mean total bilirubin 29.30 +/- 3.30 mg/dL), and in 8 normal volunteers (total bilirubin < 1 mg%). None of the patients had evidences of obvious cirrhosis, intrinisic heart disease, or septicemia. Following intravenous dobutamine there was comparable change of blood pressure and heart rate in both groups. However the response of left ventricular ejection fraction (LVEF) to dobutamine (10-mu-g/kg/min x 5 min) was strikingly blunted in the jaundiced patients as compared to that seen in the normal controls (3.56 +/- 0.9 vs. 12.7 +/- 2.2%, p < 0.005). Our present data thus show that there is blunted myocardial contractile response to the inotropic stimulation in jaundiced patients. Such myocardial refractoriness to beta-1 stimulation may contribute to the susceptibility of jaundiced patients to postoperative shock and acute renal failure.

引用

页码：15 / 22

页数：8

共 35 条

[1]

Saito H., Clinical and experimental studies on the hyperdynamic state in obstructive jaundice, Japn Surg Soc, 82, pp. 483-497, (1981)

[2]

Zollinger R.M., Williams R.D., Surgical aspects of jaundice, Surgery, 30, pp. 1016-1030, (1953)

[3]

Williams R.D., Elliot D.W., Zollinger R.M., The effect of hypotension in obstructive jaundice, Arch Surg, 81, pp. 334-340, (1960)

[4]

Dawson J.L., Acute postoperative renal failure in obstructive jaundice, Ann Roy Coll Surg Enal, 42, pp. 163-181, (1968)

[5]

Better O.S., Obstructive jaundice and acute renal failure, Contemporary Issues in Nephrology, 6, pp. 106-122, (1980)

[6]

Shasha S.M., Better O.S., Chaimovitz C., Doman J., Kishon Y., Haemodynamic studies in dogs with bile-duct ligations, Clin Sci Molec Med, 50, pp. 533-537, (1976)

[7]

Cattell W.R., Birnstingl M.A., Blood volume and hypotension in obstructive jaundice, Br J Surg, 54, pp. 272-277, (1967)

[8]

Aarseth S., Bergen A., Aarseth P., Circulatory homeostasis in rats after bile-duct ligation, Scand J Clin Lab Invest, 39, pp. 93-97, (1979)

[9]

Hishida A., Honda N., Sudo M., Nagase M., Mechanisms of altered renal perfusion in the early stage of obstructive jaundice, Kidney Int, 17, pp. 223-230, (1980)

[10]

Finberg J.P.M., Sidman R., Better O.S., Cardiovascular responsiveness to vasoactive agents in rats with obstructive jaundice, Clin Exp Pharmacol Physiol, 9, pp. 639-643, (1982)

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