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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the neonatal rabbit heart, multidose crystalloid cardioplegia is protective against normothermic ischemia, but its beneficial effects are lost under hypothermia. In order to determine the relationship between myocardial protection and the number of cardioplegic infusions administered during the ischemic period, we examined the effects of an increasing number of infusions on postischemic recovery at three temperatures (37 degrees, 20 degrees, or 10 degrees C). Isolated working hearts from rabbits aged 7-10 days were perfused aerobically (37 degrees C) for 20 min before infusion of St. Thomas' Hospital cardioplegic solution at the selected temperature. At each temperature, the cardioplegic solution was given either as a single 2-min infusion (single-dose) or as repeated 2-min infusions (multidose) at various intervals. Following the ischemic period, hearts were reperfused (15 min Langendorff, 20 min working) before assessment of the recovery of function. Ischemic durations (selected to result in approximately 55%-70% recovery in the single-dose group at each temperature) were 1, 10, or 18 h at 37 degrees, 20 degrees, and 10 degrees C. At 37 degrees C, there was a positive correlation between postischemic recovery and the number of infusions during the ischemic period. However, at 20 degrees or 10 degrees C the relationship was reversed and recovery was depressed with increasing number of infusions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Detrimental effects of multidose hypothermic cardioplegia in the neonatal heart: the role of the frequency of cardioplegic infusions. 205 51

The isometric contraction (supramaximal tetanic stimulation) of anterior tibialis muscle was studied in 32 New Zealand white rabbits after 5 hr of ischemia. Reperfusion was achieved after systemic heparinization (100 U/kg) by removal of vascular clamps (normal reperfusion, NR, N = 10); isolated pump perfusion at 15 cc/min for 30 min followed by normal reperfusion (controlled reperfusion, CR, N = 8); CR with a Sepacell 500 filter in the circuit (leukopenic, thrombocytopenic, controlled reperfusion, L/TR, N = 9); or adding 25,000 U of urokinase to the initial reperfusate (UKR, N = 5). Experimental muscle is compared to control nonischemic contralateral muscle in each animal and expressed as percentage of control function. Specimens were studied by light microscopy. No significant difference in mean function at 2 hr was seen between the four groups, with NLR having 53% of control function, CR 55% of control function, L/TR 61% of control function, and UKR 48% of control function. "No reflow," as defined by the absence of Doppler flow signals over the muscle pedicle with no recovery of function during reperfusion and continued incidence of persistent ischemia, was seen in NLR 4/10, CR 5/8, and L/TR 6/9 preparations with arteriolar, capillary, and venule thrombi documented by light microscopy. In contrast, "no reflow" was not seen in UKR (0/5, P less than 0.05). Peak function at any interval (potential maximal recovery) in muscles that adequately reperfused was best in CR (73%) and L/TR (73%). No difference in the degree of injury in adequately reperfused muscles was seen between the four groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Skeletal muscle function after ischemia: "no reflow" versus reperfusion injury. 206 59

The duration of ischemia resulting in 50% post-ischemic recovery of hemodynamic functions was 25 min in the control isolated working rat hearts and increased to 45 min in the hearts subjected to normothermic cardioplegia plus normothermic global ischemia (36 degrees C) and to 180 min in the hearts subjected to hypothermic cardioplegia and hypothermic ischemia (22 degrees C). Addition of 10(-6) M trifluoperazine to the normothermic St. Thomas' cardioplegic solution considerably improved the protective properties of the solution as assessed by the functional recovery of the heart. Under conditions of hypothermic ischemic arrest the drug failed to improve the protective properties of cardioplegic solution, suggesting a common modality between hypothermia and trifluoperazine-induced protection.
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PMID:Temperature-dependence of the effect of trifluoperazine as a protective agent during cardioplegia in the isolated working rat heart. 208 Sep 4

The effects of chronic dietary protein restriction on ischemic renal failure were evaluated in rats subjected to 90 min of bilateral renal clamping. The rats were kept on either 20% casein (regular) diet or casein-free (protein-free) diet 10 days before and 21 days after renal injury. Rats on regular protein diet showed higher levels of BUN and serum creatinine and had a lower inulin clearance (microliter/min/100 g BW) than animals on protein-free diet (289 +/- 34 vs 582 +/- 103, p less than 0.05) 2 days after ischemia. However, the inulin clearance measured 21 days following ischemia was significantly higher in rats on regular diet (1468 +/- 181) than those maintained on protein-free diet after ischemia (560 +/- 167). When unilateral 90 min ischemia was performed in rats on regular diet, the postischemic kidneys showed an incomplete recovery of the inulin clearance (226 +/- 35) compared to the contralateral kidney (900 +/- 116), 21 days after ischemia; whereas in rats on a protein-free diet the inulin clearance averaged 106 +/- 17 in the postischemic kidney and 345 +/- 41 in the right kidney. When left renal ischemia and contralateral nephrectomy were performed, the inulin clearance was 1149 +/- 74 in rats on regular diet and 534 +/- 60 in rats on protein-free diet, 21 days following renal insult. These results suggest that protein restriction can play a protective role against renal ischemia in an initial phase, but it limits the late recovery from ischemia. The presence of a normal contralateral kidney inhibits the functional recovery of the postischemic kidney and a contralateral nephrectomy produces a compensatory functional hypertrophy of the postischemic kidney, even in rats on a protein-free diet.
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PMID:The effect of protein restriction on the severity and recovery from ischemic renal failure. 210 Aug 29

Hearts which are made ischemic for relatively short periods of time, and then re-perfused, exhibit a temporary decline in tension-generating activity but are not irreversibly injured". Experiments were undertaken to find out whether such "stunned" hearts develop a perfusion defect, and whether chemically heterogeneous Ca(2+)-antagonists provide protection, when used prophylatically. "Stunning" was produced by repetitive 10 minute episodes of ischemia, followed by 15 minutes of reperfusion. The experimental model was the Langendorff-perfused rat heart, and the perfusion buffer was Krebs-Henseleit solution at 37 degrees C. To detect perfusion defects, fuchsin dye was added to the buffer. No evidence of a perfusion defect was obtained. Nevertheless, 10(-8)M nifedipine. 10(-8)M verapamil, 10(-8)M felodipine, and 10(-7)M diltiazem all conferred protection, as gauged by recovery of function after three successive 10 minute episodes of ischemia.
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PMID:Calcium antagonists and the "stunned" myocardium. 210 98

Isolated hearts from rabbits, hamsters, ferrets, gerbils, rats, mice and guinea pigs were used to investigate species differences in (i) stability during aerobic perfusion, (ii) susceptibility to ischemic injury and (iii) responsiveness to cardioplegic protection. During 120 minutes of continuous aerobic perfusion, the rate of functional deterioration differed between species. The rabbit was the most stable and the guinea pig the least: the mean +/- SEM of the left ventricular developed pressure falling, after 120 minutes of perfusion, to 82 +/- 4% and 60 +/- 6%, respectively. In studies with 30 minutes of ischemia and 60 minutes of reperfusion, the developed pressure recovered to 72 +/- 2, 71 +/- 2, 65 +/- 3, 64 +/- 2, 58 +/- 3, 50 +/- 8 and 50 +/- 2% of its pre-ischemic value in the rabbit, hamster, ferret, gerbil, rat, mouse and guinea pig, respectively. With 60 minutes of ischemia, the recovery of developed pressure in the guinea pig, rabbit, rat, mouse, hamster, ferret and gerbil was 5 +/- 1, 19 +/- 2, 22 +/- 3, 30 +/- 5, 55 +/- 4, 60 +/- 2 and 45 +/- 5%, respectively. Creatine kinase leakage and changes in tissue metabolite content generally reflected the degree of functional injury. In further studies, groups of 6 hearts were infused for 2 minutes with St. Thomas' Hospital Cardioplegic Solution, then subjected to 30 minutes of ischemia. Cardioplegia improved the recovery of developed pressure in the rabbit, hamster, gerbil, rat and mouse (from 72 +/- 2, 71 +/- 2, 64 +/- 2, 58 +/- 3 and 50 +/- 8% to 82 +/- 3, 103 +/- 3, 84 +/- 4, 77 +/- 2 and 78 +/- 5%, respectively; p less than 0.05 for each species). However, no protection was observed in the ferret and guinea pig (65 +/- 3 and 50 +/- 2% versus 66 +/- 3 and 47 +/- 6%, respectively; p = NS). With cardioplegia, tissue high-energy phosphates increased significantly in all species except the gerbil. Rat and guinea pig hearts were taken for time-response studies (ischemia for 15, 20, 30, 45, 50 and 60 minutes in the rat and 15, 30, 45 and 60 minutes in the guinea pig) with or without cardioplegia. In the rat, cardioplegia improved recovery over an ischemic time-window of 20-45 minutes, but in the guinea pig no improvement was detected. Creatine kinase leakage reflected the patterns of functional recovery. In contrast, high-energy phosphates were preserved better in both species after 30 minutes of ischemia.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Species differences in susceptibility to ischemic injury and responsiveness to myocardial protection. 210 1

The effect of pH regulation on the function of the isolated neonatal heart during continuous hypothermic perfusion and arrest was tested in 3- to 6-day-old piglet hearts. Three groups of hearts were perfused from an adult support pig, with pH varied by a carbon dioxide/oxygen gas exchanger and temperature controlled by a heat exchanger. After control function studies were obtained at normothermia with a pH of 7.4, the hearts were cooled over 15 minutes to 10 degrees C. Hypothermic perfusion was maintained for 1 hour, followed by rewarming to 37 degrees C. In group 1 (n = 5), the alpha stat (neutral) model, the blood perfusate was maintained at a pH of 7.4 (calculated at 37 degrees C). In group 2, the alkaline model, the pH was maintained at 7.9, and in group 3, the pH-stat (acid) model, the pH was maintained at 7.0. In addition, the effect of 1 hour of hypothermic ischemia after hypothermic perfusion at a pH of 7.0 was evaluated in five hearts (group 4). After rewarming no significant difference was noted in functional recovery (group 1 = 93% +/- 5%, group 2 = 92% +/- 6%, group 3 = 96% +/- 5%, and group 4 = 95% +/- 2%), oxygen consumption, coronary resistance, lactate extraction, and myocardial extravascular water content. We conclude that neonatal heart function is resistant within the range of this study to changes in pH caused by changes in carbon dioxide tension during hypothermic perfusion and ischemia.
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PMID:Effect of PCO2-adjusted pH on the neonatal heart during hypothermic perfusion and ischemia. 212 78

Abdominal aorta constriction was performed in 10-week-old Lewis rats (Aoband). Ten weeks later the hearts were isolated and attached to a non-recirculating perfusion apparatus. The hearts could eject against a diastolic aortic pressure of either 60 or 100 mmHg. The functional recovery was compared with that of hearts of sham-operated (Sham) rats. After 45 min of global ischemia, Sham hearts regained cardiac output up to 75% and 70% of the pre-ischemic levels at 60 and 100 mmHg, respectively. At 60 mmHg Aoband hearts showed a minor recovery of ejection function. However, at 100 mmHg the recovery of Aoband hearts was completely comparable with that of Sham hearts. At 60 mmHg but not at 100 mmHg, the pre-ischemic and post-ischemic coronary flow was lower in Aoband than in Sham hearts (P less than or equal to 0.05). During the initial reperfusion phase Sham hearts, perfused at 60 mmHg, released more degradation products of adenine nucleotides and lactate dehydrogenase (LDH) than Aoband hearts (P less than or equal to 0.05), while the Aoband hearts lost more degradation products and LDH than the Sham hearts later during the reperfusion phase (P less than or equal to 0.05). In the groups perfused at 60 mmHg, higher tissue levels of ATP were found in Sham than in Aoband hearts at the end of the reperfusion period (P less than or equal to 0.05). However, at 100 mmHg comparable levels were found in the Sham and Aoband hearts. It is concluded that the height of the coronary perfusion pressure is of critical importance for the post-ischemic functional recovery of the compensated hypertrophied heart. At sufficiently high perfusion pressure levels, the functional and biochemical recovery of the hypertrophied heart is at least as good as in the non-hypertrophied heart. However, in the hypertrophied heart a coronary perfusion pressure which is too low leads to relative underperfusion during the initial reperfusion period which is associated with severely depressed cardiac performance and delayed wash-out of metabolites and intracellular enzymes.
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PMID:The effects of global ischemia and reperfusion on compensated hypertrophied rat hearts. 215 Sep 72

Maintenance of low coronary flow (1 ml/min) during 40 or 70 min of anoxia maintained function and prevented Ca2+ overload during reoxygenation in isolated rat hearts. In comparison, recovery from 40 min of global ischemia resulted in only 20% of preischemic function and an increase in end-diastolic pressure (LVEDP) to 39 mmHg. Reperfusion Ca2+ uptake rose from 0.6 to 10.2 mumol/g dry tissue. Intracellular Na+ (Nai+) increased from 13 to 61 mumol/g dry tissue after 40 min of global ischemia, but was unchanged in hearts with low flow anoxia. When glucose and pyruvate were omitted from buffer used for anoxic perfusion, recovery was only 15% of preanoxic values, LVEDP rose to 32 mmHg, and reperfusion Ca2+ uptake was 7.2 mumol/g dry. In addition, Nai+ increased (47.4 mumol/g dry tissue) and ATP was depleted (1.0 mumol/g dry tissue) in the absence of substrate. In anoxic hearts supplied substrate, Nai+ stayed low (12 mumol/g dry tissue) and ATP was preserved (11.6 mumol/g dry tissue). Addition of ouabain (100 or 200 microM) and provision of zero-K+ buffer increased Nai+ and resulted in impaired functional recovery, increased LVEDP, and greater reperfusion Ca2+ uptake. These interventions also decreased energy availability in anoxic hearts. To distinguish between effects of Na+ accumulation and ATP depletion, monensin, a Na+ ionophore, was added during low flow anoxia. Monensin increased Nai+, decreased functional recovery and increased reperfusion Ca2+ uptake in a dose-dependent manner (1-10 microM) without changing ATP content. These results suggested that reduction of Nai+ accumulation by maintenance of Na+, K+ pump activity was the major mechanism of the beneficial effects of low coronary flow on reperfusion injury.
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PMID:Na+ accumulation increases Ca2+ overload and impairs function in anoxic rat heart. 215 54

The purpose of this study was to use a direct method, that of electron spin resonance (ESR) spectroscopy, to demonstrate that reperfusion after a period of ischemia results in a sudden increase in the production of free radicals in the myocardium. Furthermore, the role of free radicals in the development of reperfusion arrhythmias and functional disturbances also was investigated using a 30-min period of global ischemia followed by 30 min of reperfusion in the isolated working rat heart. The spin trapping agent 5,5-dimethyl-1-pyrroline-1-oxide (DMPO) when it perfused the heart, 100 mumoles/liter, during the first 10 min of reperfusion attenuated the development of reperfusion arrhythmias and improved the functional recovery of the heart during reperfusion. Without treatment, 55% of hearts showed irreversible ventricular fibrillation, and this was completely prevented by DMPO. In DMPO-treated hearts, the recovery of heart function was improved; thus, coronary flow, aortic flow, left ventricular developed pressure, and first derivative of left ventricular developed pressure were significantly increased from their maximal control values of 16.2 +/- 1.9 ml/min, 12.7 +/- 0.9 ml/min, 11.1 +/- 0.5 kPa, and 426 +/- 31 kPa/s to 21.8 +/- 1.3 ml/min (p less than 0.05), 28.4 +/- 3.0 ml/min (p less than 0.001), 14.5 +/- 1.0 kPa (p less than 0.01), and 584 +/- 41 kPa/s (p less than 0.01), respectively. Left ventricular end-diastolic pressure was also significantly reduced from its control value of 2.8 +/- 0.2 kPa to 2.1 +/- 0.2 kPa (p less than 0.05), while the recovery of heart rate was not improved by DMPO treatment. Parallel ESR studies using DMPO as spin trap demonstrated the formation of .OH radicals in the effluent of the reperfused hearts. ESR signals of the formed DMPO-OH, alpha N = alpha beta H = 1.48 mT, were observed within the first seconds of reperfusion with peak concentrations after about 3 min. In the first series of ESR studies, DMPO (200 mmol/liter) was mixed up effluent and ESR signals were recorded, while in the second series of studies, DMPO was directly infused into the heart. Both methods were appropriate to demonstrate the radical formation that peaked at 3 min of reperfusion after 30 min of global ischemia. Cardiotoxic effects of DMPO can be excluded by using of the "mix-up" method (DMPO is added to effluent) because relatively high DMPO concentration (20-200 mmol/liter) is important for demonstration of free radical production.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Heart protection and radical trapping by DMPO during reperfusion in isolated working rat hearts. 216 75


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