Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042510 (ventricular fibrillation)
 10,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Blood cardioplegia (BCP) has been reported as a superior method of myocardial protection, because of its oxygenating and buffering potential, but it is unknown which temperature is most effective. This study was performed to investigate the efficacy of continuous warm blood cardioplegia (CWBCP) versus continuous cold blood cardioplegia (CCBCP) in regard to metabolism, serum enzyme release, cardiac function and edema. Fourteen adult mongrel dogs were subjected to total cardiopulmonary bypass and cross-clamp of the aorta for 120 minutes, and followed by 60 minutes' reperfusion. The dogs were divided into two groups according to the differences of BCP temperature: Group W, 33 degrees C warm BCP, and Group C, 16 degrees C cold BCP with topical cooling. Myocardial oxygen extraction during aortic cross-clamping was significantly higher in group W than in group C. Changes in excess lactate (delta XL) and redox potential (delta Eh) of lactate and pyruvate showed that aerobic metabolism could be maintained in group W and could not in group C. Lipid peroxides (LPO) were measured in coronary artery and sinus blood at the same time, so generations of LPO (A-Cs difference) at 5 minutes after reperfusion were significantly lower in group C than in group W (-0.140 +/- 0.125 nmol/ml V.S. 0.019 +/- 0.093). The incidence of ventricular fibrillation after reperfusion was significantly lower in group W than in group C (1/7 V.S. 7/7). CPK-MB and HBDH releases were significantly lower in group W than in group C during aortic clamp and 60 minutes' reperfusion (47 +/- 15 IU/l, 138 +/- 72 V.S. 94 +/- 24, 229 +/- 71).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A comaprative study of continuous warm blood cardioplegia]. 837 85

The protective effects of captopril were evaluated in vitro on isolated perfused rat hearts after a global ischemia of 20 min. The hearts were randomly allocated in 2 groups. In the first one (n = 6) captopril was added at a concentration of 270 microM. The second one was utilized as control (n = 6). Aortic flow and minute work respectively decreased on reperfusion by 35% and 49% in captopril group and by 65% and 71% in controls (p < 0.001). No changes occurred in heart rate. Aortic systolic pressure and coronary flow decreased in the 2 groups, but not significantly. Myocardial enzyme release during reperfusion showed significant lower levels of CPK and LDH in the captopril group as compared to controls (p < 0.001 after 41 min). The occurrence of serious ventricular arrhythmias was considerably higher in controls with respect to the captopril group. Irreversible ventricular fibrillation occurred only in control hearts (50%). These data indicate that captopril exerts a protective effect during myocardial ischemia and reperfusion by preventing serious ventricular arrhythmias, reducing enzymatic release and a lower decrease in cardiac performance, without an increase in heart rate.
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PMID:[The myocardial protective effects of cardiac tissue ACE inhibition in experimental ischemia-reperfusion in isolated rat hearts]. 839 28

The present study indicates that iv tetrandrine may transiently decrease blood pressure, while other hemodynamic parameters such as LVP, +/- dp/dtmax, LVEDP, HR and CO may not be significantly altered. During coronary occlusion three of five dogs developed ventricular fibrillation (VF) and died in the control group, i.e. incidences of VF and mortality were 60%. While tetrandrine (Tet) appeared to reduce the severity of ischemic injury. It may alleviate arrhythmia and prevent VF and death in four of the five dogs. Tet also attenuated Ca2+ accumulation in myocardial cell, reduced melondialdehyde (MDA) production in ischemic myocardial and decreased CPK release in comparison with the control. It appears that Tet may have significant protective effects against ischemia induced cardiac damage in anesthetized dogs.
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PMID:[Protective effects of tetrandrine on ischemic myocardia in anesthetized dogs]. 870 39

A 37-year-old woman was taken to a hospital because of sudden chest pain. She lapsed into shock, and the ECG indicated acute myocardial infarction. The ECG later showed ventricular fibrillation, and the patient was given cardiac massage while being transported to our hospital, where she was resuscitated with a percutaneous cardiopulmonary support system. Emergency coronary angiography revealed 99% stenosis of the left main coronary artery. PTCA was performed, and the stenotic lesion was released, but dissection and rapid formation of a thrombus were detected in the LAD. Re-PTCA was performed, but the hemodynamics did not improve, and emergency CABG of the LAD, D1, and LCx was performed. Postoperative max CPK was 18,957 IU/L. Although postoperative MRSA pneumonia developed as a complication, weaning from the respirator was performed 17 days after the operation. The patient was discharged, ambulatory, 74 days after the operation.
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PMID:[Successful emergency coronary artery bypass grafting after use of a percutaneous cardiopulmonary support system in a patient with cardiopulmonary arrest secondary to acute myocardial infarction]. 988 66

To clarify the optimal management and delineate the characteristics of patients with severe left main disease and cardiogenic shock as a result of an acute anterolateral myocardial infarction (left main shock syndrome), we analyzed the course of 13 such patients from September 1989 to June 1997. Of the 13 patients, 7 (53.8%) were managed with emergency coronary angioplasty (group A), 3 (23.1%) were treated with emergency coronary angioplsty following coronary bypass graft surgery (group B) and 3 (23.1%) underwent emergency coronary bypass graft surgery alone (group C). The interval from the beginning of myocardial ischemia to revascularization was 266 +/- 303 min. The degree of diameter stenosis found in the left main coronary artery was 98.1 +/- 1.8%. Overall in-hospital mortality for the 13 patient with left main shock syndrome was 76.9% (group A: 7/7; group B: 1/3; group C: 2/3, NS) and operative mortality was 61.5% (group A: 6/7; group B: 0/3; group C: 2/3, p = 0.03). When all 13 patients were examined together, the presence of ventricular tachycardia (VT) x ventricular fibrillation (Vf) was found to be the most powerful univariate predictor of operative death (p = 0.03). This is, 7 (87.5%) of the 8 patients with VT x Vf at presentation died within 30 postoperative days, and only 1 (20%) of the 5 patients without VT x Vf died (p = 0.03). Age, percent stenosis of the left main or right coronary arteries, the interval from the beginning of myocardial ischemia to revascularization, intubation, systolic pressure, fractional shortning, pulmonary artery pressure, pulmonary capillary wedge pressure, coronary risk factors, pulmonary edema, mitral regurgitation and percutaneous cardiopulmonary support failed to attain univariate significance at the P = .1 level. The postoperative peak CPK level was 15665 +/- 6710 IU/1 in operative death compared to 4733 +/- 2749 IU/1 in operative survival (p = 0.01). In conclusion, emergency coronary angioplasty following coronary bypass graft surgery for left main shock syndrome has been a very successful therapeutic option. Finally, for the entire group of 13 patients with left main shock syndrome, VT x Vf significantly decreased short-term survival.
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PMID:[Prognosis and management in patients with left main shock syndrome--emergency PTCA following CABG]. 1003 32

Rabdomyolysis usually occurs after trauma and release of myoglobin from the damaged muscle, i.e.; after ishchemic myopathy due to arterial occlusion or malignant hyperthermia. We encountered a pediatric case of rhabdomyolysis after Ross-Konnos' operation in an 8-yr-old girl with aortic regurgitation. After the first weaning from cardiopulmonary bypass (CPB), ventricular fibrillation occurred due to an insufficiency in coronary blood flow and CPB was resumed with rapid cooling of body temperature. The total CPB lasted for 5 hr 43 min. After the second weaning from CPB, myoglobinuria was found. Furthermore, blisters and abrasions appeared on her back and CPK levels were abnormally elevated (maximum 19,132 IU.l-1) without any elevation of body temperature in the postoperative course. Rhabdomyolysis due to intraoperative hypoperfusion was suspected and diuretics were administrated with a large amount of crystalloid to maintain urine output. The patient showed a good clinical course without acute renal failure. The course of this case suggests that rhabdomyolysis is one of rare complications of CPB and an early correct diagnosis of rhabdomyolysis and forced diuresis at an early stage are important to avoid acute renal failure.
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PMID:[A case of rhabdomyolysis after open heart surgery in a child]. 1121 44


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