Acute effects of amrinone on regional myocardial and systemic blood flow distribution in the dog

1982 ◽  
Vol 60 (6) ◽  
pp. 811-818 ◽  
Author(s):  
Stanley Einzig ◽  
Gundu H. R. Rao ◽  
Mary Ella Pierpont ◽  
James G. White

The effect of bolus intravenous injections of amrinone (1–2 mg/kg) on abdominal organ, central nervous system, and myocardial blood flow distribution was examined in 15 anesthetized dogs. Blood flows were measured during control conditions and 5 and 60 min following drug administration using left atrial injection of 15-μm radionuclide-labeled spheres. Analysis of variance revealed that blood flow changes were similar in dogs receiving either drug dose (P > 0.10). Five minutes following injection, blood flow was increased (all P < 0.05) in the renal cortex (+20.4%), spleen (+40.4%), and liver (+47.1%); flow was unchanged in other abdominal organs (pancreas, gallbladder, small and large intestine, and fundic and antral gastric mucosa) and the central nervous system (cervical spinal cord, pons, medulla, dorsal thalamus, cerebellum, caudate nucleus, and cerebral cortical gray and white matter); and flow was reduced in the triceps muscle (−23.7%). At this time, left ventricular flow was increased (+25.0%) and the left ventricular subendocardial/subepicardial (Endo/Epi) flow ratio was reduced (1.09 ± 0.02 (SE) vs. 0.90 ± 0.02, P < 0.001). Sixty minutes following injection, renal and hepatic flows had returned to control values while splenic flow remained increased (+61.6%); intestinal, gastric mucosal, gallbladder, and triceps flows were reduced by values ranging from 26.7 to 38.9% and central nervous system perfusion was reduced by values ranging from 11.8 to 19.4% in all regions except the caudate nucleus. Although left ventricular flow had returned to control values, the Endo/Epi ratio (1.02 ± 0.02) remained minimally reduced at this time (P < 0.001). These results suggest that vascular responsiveness to intravenous amrinone is not uniform in different circulatory beds and that relative subendocardial under-perfusion of the left ventricular myocardium occurs following bolus intravenous amrinone injections in the dog.

1985 ◽  
Vol 63 (7) ◽  
pp. 787-797 ◽  
Author(s):  
Jacques R. Rouleau ◽  
Michel White

Coronary sinus pressure (Pcs) elevation shifts the diastolic coronary pressure–flow relation (PFR) of the entire left ventricular myocardium to a higher pressure intercept. This finding suggests that Pcs is one determinant of zero-flow pressure (Fzf) and challenges the existence of a vascular waterfall mechanism in the coronary circulation. To determine whether coronary sinus or tissue pressure is the effective coronary back pressure in different layers of the left ventricular myocardium, the effect of increasing Pcs was studied while left ventricular preload was low. PFRs were determined experimentally by graded constriction of the circumflex coronary artery while measuring flow using a flowmeter. Transmural myocardial blood flow distribution was studied (15-μm radioactive spheres) at steady state, during maximal coronary artery vasodilatation at three points on the linear portion of the circumflex PFR both at low and high diastolic Pcs (7 ± 3 vs. 22 ± 5 mmHg; p < 0.0001) (1 mmHg = 133.322 Pa). In the uninstrumented anterior wall the blood flow measurements were obtained in triplicate at the two Pcs levels. From low to high Pcs, mean aortic (98 ± 23 mmHg) and left atrial (5 ± 3 mmHg) pressure, percent diastolic time (49 ± 7%), percent left ventricular wall thickening (32 ± 4%), and percent myocardial lactate extraction (15 ± 12%) were not significantly changed. Increasing Pcs did not alter the slope of the PFR; however, the Pzf, increased in the subepicardial layer (p < 0.0001), whereas in the subendocardial layer Pzf did not change significantly. Similar slopes and Pzf were observed for the PFR of both total myocardial mass and subepicardial region at low and high Pcs. Subendocardial: subepicardial blood flow ratios increased for each set of measurements when Pcs was elevated (p < 0.0001), owing to a reduction of subepicardial blood flow; however, subendocardial blood flow remained unchanged, while starting in the subepicardium toward mid-myocardium blood flow decreased at high Pcs. This pattern was similar for the uninstrumented anterior wall as well as in the posterior wall. Thus as Pcs increases it becomes the effective coronary back pressure with decreasing magnitude from the subepicardium toward the subendocardium of the left ventricle. Assuming that elevating Pcs results in transmural elevation in coronary venous pressure, these findings support the hypothesis of a differential intramyocardial waterfall mechanism with greater subendo- than subepi- cardial tissue pressure.


1990 ◽  
Vol 258 (6) ◽  
pp. H1642-H1649 ◽  
Author(s):  
D. G. Van Wylen ◽  
J. Willis ◽  
J. Sodhi ◽  
R. J. Weiss ◽  
R. D. Lasley ◽  
...  

The purpose of this study was twofold: 1) to investigate the feasibility and usefulness of cardiac microdialysis for the simultaneous estimation of regional cardiac interstitial fluid (ISF) adenosine (ADO) concentration and coronary blood flow (CBF); and 2) to determine the changes in the ISF levels of ADO and CBF during cardiac stimulation or regional myocardial ischemia. Cardiac microdialysis probes were implanted in the left ventricular myocardium of chloralose-urethan-anesthetized dogs and perfused with Krebs-Henseleit buffer. The concentration of ADO in the effluent dialysate was used as an index of intramyocardial ISF ADO concentration while local CBF was measured by H2 clearance via a platinum wire within the dialysis fiber. Dialysate ADO was elevated immediately after insertion of the microdialysis probe, declined rapidly in the first 20 min, stabilized by 60 min, and remained constant for 2 h. Based on the relationship in vitro and in vivo between microdialysis probe perfusion rate and dialysate ADO concentration, ISF ADO concentration within the left ventricular myocardium was estimated to be 0.9-1.3 microM. Dobutamine (10 micrograms.kg-1.min-1) infusion resulted in a 36% increase in CBF and a 2.5-fold increase in dialysate ADO (n = 9; P less than 0.05). Regional myocardial ischemia, induced by occlusion of the left anterior descending artery (LAD), caused a 13-fold increase in dialysate ADO in the LAD perfused myocardium (n = 9; P less than 0.05). These results are consistent with the ADO hypothesis and suggest that cardiac microdialysis provides a reliable technique for the sampling of regional intramyocardial ISF.


2001 ◽  
Vol 91 (1-2) ◽  
pp. 47-54 ◽  
Author(s):  
John G Kingma ◽  
Bengt Linderoth ◽  
Jeffrey L Ardell ◽  
John A Armour ◽  
Michael J.L DeJongste ◽  
...  

1980 ◽  
Vol 238 (5) ◽  
pp. H736-H739 ◽  
Author(s):  
J. Bhattacharya ◽  
L. J. Beilin

When cannulation of the left ventricle and the left atrium were compared as methods for measuring for measuring renal blood flow distribution with radioactive microspheres in 9 conscious and 6 anesthetized rabbits, there were no differences between the two injection routes. Left ventricular cannulation per se did not affect cardiac output, nor the percentage of the cardiac output supplying the kidneys; but cardiac outputs estimated by thermodilution by injections via this route were up to 10% greater than those from left atrial injection. The advantages of left ventricular cannulation for experiments on regional blood flow distribution in conscious animals are discussed.


2019 ◽  
Vol 1 (8) ◽  
pp. 26-29
Author(s):  
S. V. Peshkova ◽  
M. V. Chistyakova ◽  
V. S. Barcan

The paper analyzes the results of examinations of 24 patients with viral cirrhosis of classes B and C according to Child-Pugh criteria. The control group consisted of 16 healthy patients. Patients with viral cirrhosis were divided into 2 groups: 1 group consisted of 14 patients with pseudonormokinetic type of portal blood flow; Group 2-10 patients with hyperkinetic type of portal blood flow with predominant acceleration of the linear velocity in the portal vein. The average age of patients was 35.2 ± 7.4 years. Left ventricular myocardium mass and left ventricular myocardium mass index were determined in all the patients; the diameter and the maximum linear velocity in the main portal vein were measured using an Artida pro Toshiba apparatus, Japan. Heart rate variability was studied at rest and in active orfhostasis using the «Neuro-Soth)program, Ivanovo. it was found that in patients with liver cirrhosis the sympathetic effects of the autonomic nervous system predominated, which coincided with the literature data. It was also shown that in patients with the pseudonormokinetic type of portal blood flow these effects were more pronounced. The relationship between HRV indices and the formation of left ventricular hypertrophy in patients with pseudo-normokinetic type of portal blood flow was revealed.


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