RESUMO
Cardiac function improvement seen with hemofiltration may be attributable to "cardiac depressant factor(s)" removal. The authors have attempted "factor" isolation. Initial 12 hr hemofiltrate was obtained from: 4 patients with acute congestive heart failure (cardiac index: 2.02 +/- 0.48) and acute renal failure (blood urea nitrogen [BUN] 97.7 +/- 32.7; serum creatinine [SCr] 6.2 +/- 3.4 mg%) (Group I); 8 patients with chronic congestive heart failure (CI: 2.69 +/- 1.3) and mild renal failure (BUN 48.8 +/- 31.4; SCr 3.5 +/- 2.4 mg%) (Group II); and 8 patients with end-stage renal disease and no congestive heart failure (Group III). Crude samples were passed through C18Sep-Pak, and eluted with methanol/water mixtures, and 50% methanol samples were fractionated by high pressure liquid chromatography. Inotropic response was studied by injecting samples (in Krebs-Hensleit buffer) into a Langendorff rat heart preparation. The effect of pH, acetate, salts, and adding propranolol on the inotropic response also was tested. Myocardial depression followed all vehicle and preparatory elements: 0.1 M HCl (-47%); 0.08 M acetic acid (-75%); Na acetate (-25%); 0.1 M NaHCO3 (-11%); Na citrate (-84%); and Na glutarate (-14%). Group I had biphasic responses, the positive inotropism accorded to catecholamines, whereas negative inotropism was equal in each patient (-40.3%). Group II had a biphasic response with negative (-15%) inotropism noted. Group III was weakly biphasic. The data indicate there was myocardial depressive activity, most pronounced in Groups I and II, after method interference was corrected.
Assuntos
Injúria Renal Aguda/sangue , Injúria Renal Aguda/terapia , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/terapia , Hemofiltração , Fator Depressor Miocárdico/isolamento & purificação , Injúria Renal Aguda/complicações , Animais , Cromatografia Líquida de Alta Pressão , Coração/efeitos dos fármacos , Insuficiência Cardíaca/complicações , Hemofiltração/métodos , Humanos , Técnicas In Vitro , Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Contração Miocárdica/efeitos dos fármacos , Fator Depressor Miocárdico/farmacologia , RatosAssuntos
Hemorragia/sangue , Fator Depressor Miocárdico/sangue , Peptídeos/sangue , Choque Traumático/sangue , Animais , Depressão Química , Cães , Hemorragia/complicações , Humanos , Técnicas In Vitro , Peso Molecular , Contração Miocárdica/efeitos dos fármacos , Fator Depressor Miocárdico/isolamento & purificação , Fator Depressor Miocárdico/farmacologia , Choque Traumático/complicaçõesRESUMO
Myocardial depressant factor (MDF) was isolated from dog pancreas after incubation at 37 degrees C for 2 hr. A highly purified preparation of MDF was obtained by paper chromatography and high voltage electrophoresis. After paper chromatography of crude homogenates of the pancreatic tissue, cardiodepressant activity was found in spot F. High voltage electrophoresis of spot F produced five separate fractions. Bioassay using isolated perfused hearts and cultures of myocytic tissue showed that only one of these spots was associated with MDF activity. This spot contained a peptide with a molecular weight of 1000-2500 consisting of nine amino acids.
