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Titolo:
LOWERED THRESHOLD FOR VENTRICULAR-FIBRILLATION IN AMIODARONE-TREATED PIGS UNDERGOING CARDIOPULMONARY BYPASS AND CARDIOPLEGIC ARREST WITH ST-THOMAS CARDIOPLEGIC SOLUTION
Autore:
GOTZSCHE LSB; PEDERSEN EM; PAULSEN PK;
Indirizzi:
AARHUS KOMMUNE HOSP,DEPT MED DIABET & ENDOCRINOL DK-8000 AARHUS DENMARK
Titolo Testata:
European journal of cardio-thoracic surgery
fascicolo: 4, volume: 7, anno: 1993,
pagine: 186 - 192
SICI:
1010-7940(1993)7:4<186:LTFVIA>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Keywords:
AMIODARONE; CARDIAC SURGERY; CARDIOPLEGIC SOLUTIONS; ST-THOMAS SOLUTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
L.S.B. Gotzsche et al., "LOWERED THRESHOLD FOR VENTRICULAR-FIBRILLATION IN AMIODARONE-TREATED PIGS UNDERGOING CARDIOPULMONARY BYPASS AND CARDIOPLEGIC ARREST WITH ST-THOMAS CARDIOPLEGIC SOLUTION", European journal of cardio-thoracic surgery, 7(4), 1993, pp. 186-192

Abstract

The antiarrhythmic agent amiodarone has been suspected of causing reduced cardiac performance after extra-corporeal circulation and cardioplegic arrest in patients. This has recently been confirmed in an experimental model where pigs were exposed to cardiopulmonary bypass and cold cardioplegic arrest with Bretschneider's solution. Due to the high concentration of the cardio-depressant agent procain in Bretschneider's solution, it could be speculated whether it is the combination of amiodarone and this solution that may be potentially deleterious, ratherthan amiodarone alone. To investigate this, adult pigs (75 +/- 2 kg at surgery) were treated with amiodarone for 30 +/- 2 days (1400 mg/day: n = 8, untreated controls: n = 4, blind experiment), followed by exposure to cardiopulmonary bypass with universal cooling to 28-degrees-Cand topical cold cardioplegic arrest with St. Thomas' solution for 60min. Apart from 1 g of calcium (Ca2+) at the end of bypass, no inotropic drugs were administered. Cardiac reserve was tested by right ventricular pacing (200 beats/min until death or up to 30 min). The two groups did not differ concerning preload or afterload, heart rate, cardiac output, left ventricular pressure, arterial pressure or rate of change in left ventricular relaxation (- dP/dt) before or after bypass wasterminated, while the rate of change in left ventricular contraction (+ dP/dt) was lower in the amiodarone-treated pigs. The time on bypass, before stable hemodynamics had recovered, was prolonged in amiodarone-treated animals, 46 +/- 4 min versus 31 +/- 3 min in the controls (P< 0.05). Aminodarone-treated animals survived 2.7 +/- 1.8 min of pacing, while controls survived 29.0 +/- 1.0 min (P < 0.0001). In the amiodarone-treated animals, initiation of pacing resulted in an almost immediate direct current (DC)-resistant ventricular fibrillation in all but one, while no episodes of tachyarrhythmias occurred in any of the controls during pacing. This markedly lowered threshold for induction of ventricular fibrillation in amiodarone-treated pigs exposed to St. Thomas' solution differs from the previous observation made in amiodarone-treated pigs exposed to Bretschneider's solution, as those pigs suffered from primary pump failure. The possibility that the two observations may represent only quantitative differences of the same phenomenon is discussed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 07:33:54