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BACKGROUND: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S′) in patients undergoing cardiac surgery. METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S′ at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography. RESULTS: Mean S′ values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8–12.2), 9.5 (8.3–10.8), and 8.4 (7.3–9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were −1.0 (−1.6, −0.3), −1.1 (−1.7, −0.6), and −2.1 (−3.1, −1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001). CONCLUSION: Isoflurane increments (1.0–2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.
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Humanos , Anestesia , Ecocardiografia , Ecocardiografia Transesofagiana , Testes de Função Cardíaca , Valvas Cardíacas , Isoflurano , Análise Multivariada , Fenilefrina , Cirurgia TorácicaRESUMO
Objective: To explore the impact of knocking out wildtype p53 phosphatase 1 gene on heart function with the changes of cardiac tissue mRNA and protein expressions in experimental mice. Methods: Our research included in 2 groups: Wildtype (WT) mice group and Wip1 knockout (Wip1-KO) mice group. n=10 in each group. The heart function, ratio of heart weight to body weight (HW/BW) were examined and compared between 2 groups; cardiac tissue morphology was observed by HE staining; mRNA expressions of ANP, BNP, MCP-1 andα-SMA were determined by RT-PCR and protein expressions of Bcl-2, Bax and c-caspase3 were measured by Western blot analysis. Results: Compared with WT mice group, Wip1-KO mice group showed decreased Wip1 mRNA expression,P0.05; apoptosis related protein expressions of Bax/Bcl-2 and c-caspase3 were similar between 2 groups,P>0.05. Conclusion: Wip1 gene knockout may impair the heart function in experimental mice, while the relevant mechanism should be further investigated.
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Objective: To explore the relationships between blood levels of osteopontin (OPN), brain natriuretic peptide (BNP) and cardiac function in patient with degenerative heart valve disease (DHVD). Methods: Our research included in 2 groups: DHVD group,n=120 relevant patients treated in our hospital from 2013-12 to 2015-02 and Control group,n=30 healthy subjects from physical examination in the same period of time. Based on blood levels of OPN, DHVD patients were further divided into 2 sub-groups as Normal OPN sub-group, the patients with 18.8 ng/ml ≤OPN≤ 30.0 ng/ml,n=35 and High OPN sub-group, the patients with OPN>30.0 ng/ml,n=85. OPN levels at prior treatment (T0) and 3 days (T1), 1 week (T2), 2 weeks (T3) after treatment were compared between DHVD group and Control group; BNP levels, cardiac outcome (CO), cardiac index (CI) and left ventricular ejection fraction (LVEF) were also compared. The relationships between blood levels of OPN, BNP and cardiac function in DHVD patients were studied by Pearson correlation analysis. Results: Compared with Control group at T0 time point, High OPN sub-group showed increased blood levels of OPN and BNP, while decreased CO, CI and LVEF. Compared with Normal OPN sub-group, High OPN sub-group had the higher levels of OPN and BNP at all 4 time points, while lower levels of CO, CI and LVEF. In DHVD group, compared with T0 time point, OPN and BNP levels were decreased at T2 and T3 time points, while CO, CI and LVEF were increased, allP<0.05. Pearson correlation analysis presented that in DHVD patients, blood levels of OPN were positively related to BNP (r=0.936,P=0.00) and negatively related to CO, CI and LVEF (r=-0.869,r=-0.884 andr=-0.858 respectively, allP=0.00). Conclusion: DHVD patients had increased blood level of OPN which is related to BNP level and cardiac function; this might be because of OPN promoting heart valve calciifcation, inlfammatory reaction and myocardial injury. OPN could be used as a reference index for evaluating the cardiac function in DHVD patients.
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Objective: To investigate the efifcacy of supplemental walking training in patients with coronary artery disease (CAD) combining heart failure (HF) under routine medication. Methods: A total of 80 patients with CAD combining HF were randomly divided into 2 groups: Exercise group,n=40 including 25 male and 15 female at (61.2 ± 9.8) years of age, the patients received additional six-minute walking exercise training based on routine medication and Control group,n=40 including 26 male and 14 female at (58.1 ± 10.9) years of age, the patients received routine medication. All patients were treated for 3 months. Plasma levels of BNP and general conditions at before and after the treatment were compared between 2 groups. Results:①After 3 months treatment, both groups had signiifcantly improved LVESD, LVEDD, LVEF, plasma levels of BNP and six-minute walk test (except LVESD and LVEDD in Control group), allP Conclusion: Walking training may increase the exercise tolerance, which is beneifcial to recover the cardiac function in patients with CAD combining HF in addition to routine medication .
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Objective To assess the effects of Guanxinshutong capsule(GXST)on protection of left ventricular(LV)function after acute myocardial infarction(AMI)in rats.Methods Twenty-eight male Sprague Dawley rats were randomized to Model group,Drug group and Sham-operated group,with acute myocardial infarction(AMI)achieved by ligating coronary artery in Model and Drug groups.From one week before surgery to four weeks after surgery,GXST for Drug group(1.5 g/kg,2 times/day)or saline for Model and Sham-operated groups was administered via direct gastric gavage.After four weeks of treatment following surgery,measurement of LV function,pathohistological observation and analysis were performed.Results Compared with rats in the Model group,LV systolic pressure(LVSP)[(97.7 ± 9.0)mm Hg (1 mm Hg =0.133 kPa)vs(85.9 ±9.4)mm Hg],the maximum rising rate of LV pressure(+ dp/dtmax)[(4810.2 ± 595.0)mm Hg/s vs(3786.2 ± 723.0)mm Hg/s]and the maximum dropping rate of LV pressure(-dp/dtmax)[(3781.6 ±573.6)mm Hg/s vs(2774.4 ±633.5)mm Hg/s]in the Drug group were significantly increased,while LV end-diastolic pressure(LVEDP)[(10.3 ± 0.7)mm Hg vs(12.7 ±2.4)mm Hg]in the Drug group was significantly decreased(all P ＜ 0.05).Myocardial pathohistological morphology was improved in the Drug group with fibrosis alleviated[(5.13 ± 1.37)％ vs(7.27 ±1.01)％]and infarct size reduced[(20.14 ± 8.49)％ vs(31.90 ± 4.98)％].Apoptosis index(AI)was decreased[(14.05 ± 4.04)％ vs(20.87 ± 6.03)％]and vessel density was significantly increased by 1.48-fold in the Drug group(all P ＜ 0.05).Conclusions GXST is effective in protecting LV function after AMI in rats,which may be affect through increasing vessel density of infarction area,improving myocardial pathohistological morphology,alleviating fibrosis,reducing infarct size and decreasing AI.
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The LVdP/dtmax, LVSP, AP and Vmax of the rat hearts in vivo were increased by Sophoridine ( 2 mg/kg, given to rats iv ) by 19.5, 13.1, 14.8 and 28.2% respectively. Such a positive inotropic effect lasted for more than 5 min and was statistically significant. Adrenaline (0.16 ?g/kg, iv ) could also increase the LVdP/dtmax and Vmax of the heart obviously and this action was not stronger than Sri after uses of drugs except at 0.5 min and vanished more quickly. There was an increment of MVO2I because of the increased arterial pressure within 3 min after use of Sri, which was much less than adrenaline. The present results show Sri strengthened the cardial force for longer time and affected the arterial pressure and MVO2I less than adrenaline in the rat hearts in vivo.
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Aim To investigate the effects of Isofluraneon function,metabolism,ATPase activity and free radicals in isolated ischemia /reperfusion(I/R) rat hearts.Methods 56 SD rats were randomly divided into 7 small groups(n=7),or 2 big groups according to given drug.In a normal thermal isolated Langendorff rat heart model,Myocardial Adenosine triphosphate(ATP),Malodialdehyde(MDA),Activity of Ca2+-ATPase,Na+,K+-ATPase and Superoxide Dismutase(SOD)were determined.Results In isoflurane group,LVDP and dp/dt decreased,CF and ATP increased while the activity of Na+,K+-ATPase remained unchanged.The myocardial ATP content decreased slowly in isoflurane group.At the end of reperfusion,ventricular function,CF,myocardial ATP content and the activity of Ca2+-ATPase and SOD in isoflurane group were significantly higher while myocardial MDA was significantly lower than those in control group.Conclusion Isoflurane can depress myocardial systolic function and activity of Ca+-ATPase in normal myocardium,improve the recovery of function and metabolism,and increase CF and the activity of Ca2+-ATPase and Na+,K+-ATPase.
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Diastolic transmitral blood flow was measured by Doppler echocardiography in 66 patients with hypertension and 33 normal persons. The results showed that isovolumic ventricular relaxation time and peak. A velocity increased and E/A ratio decreased significantly in hypertensive patients without left ventricular (LV) hypertrophy. Patients with LV hypertrophy had not only significant change of these parameters, but also significant decrease of peak E velocity and deceleration of E velocity. Left atria was larger in hypertensive patients, especially in those with LV hypertrophy. It is suggested that LV diastolic dysfunction in patients with hypertension may occur before the development of LV hypertrophy, and LV hypertrophy may worsen the diastolic dysfunction.
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The left ventricular functions of 72 patients with arrhythmias were studied with a ?-cardiac function device The LVEF was normal in only 11 cases(17.5%) and was reduced in 61 cases(82.5%) The systolic functions including EF,SV,and RCO and the diastolic functions such as PFR were all lower than normal in all the groups of arrhythmic patients,and the difference was significant(P
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Objective:To assess the effects of different fluid therapies on myocardial function,blood-spinal cord barrier and water content of spinal cord after acute high level spinal cord injury(SCI) in rats.Methods: Thirty-two male SD rats, weighing (300?20) g, were anesthetized intraperitoneally with pentobarbital (40 mg/kg). A cervical laminectomy extending from C6-T1 was performed and the experimental acute cervical 7 spinal cord injury model was created by modified Allen’s method,and then the rats were randomly divided into 4 groups(n=8): control group(C group) with no fluid resuscitation, 7.5% hypertonic saline group(HS group), 6% hydroxyethyl starch group(HES group) and banlanced solution group (BS group).Fifteen minutes after injury, rats of each treatment groups were given (iv. at 4 ml/kg) above-mentioned fluids in 4 min,then continuously infused at a rate of 10 ml?kg -1 ?h -1 over for 30 min.MAP,HR,left ventricular systolic pressure (LVSP),and ?dp/dt max were recorded at 5,15 and 30 min.At 30 min, 0.5% Evan's blue(EB) 1 ml was injected iv.Two hours later the animals were sacrificed and the injured segments of spinal cords were removed for determination of water content and EB content.Results:After SCI there were no differences of HR at different time points in each group. At 5 min,HS significantly increased MAP,LVSP and ?dp/dt max compared with control group(P