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Andrasi T, Kékesi V, Merkely B, Großmann M, Danner B, Schöndube F. A Minimally Invasive Approach for Open Surgical Thoracoabdominal Aortic Replacement: Experimental Concept for a Novel Surgical Procedure. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T.B. Andrasi
- Georg August University of Göttingen, Department of Thoracic and Cardiovascular Surgery, Göttingen, Germany
| | - V. Kékesi
- Semmelweis University Budapest, Heart and Vascular Center, Budapest, Hungary
| | - B. Merkely
- Semmelweis University Budapest, Heart and Vascular Center, Budapest, Hungary
| | - M. Großmann
- Georg August University of Göttingen, Department of Thoracic and Cardiovascular Surgery, Göttingen, Germany
| | - B.C. Danner
- Georg August University of Göttingen, Department of Thoracic and Cardiovascular Surgery, Göttingen, Germany
| | - F.A. Schöndube
- Georg August University of Göttingen, Department of Thoracic and Cardiovascular Surgery, Göttingen, Germany
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Molnár GF, Nemes A, Kékesi V, Monos E, Nádasy GL. Maintained geometry, elasticity and contractility of human saphenous vein segments stored in a complex tissue culture medium. Eur J Vasc Endovasc Surg 2010; 40:88-93. [PMID: 20171909 DOI: 10.1016/j.ejvs.2010.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Accepted: 01/14/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Improved maintenance of endothelial function and higher viability of saphenous vein grafts stored in a complex tissue culture medium (TCM) have been demonstrated. This article studies the biomechanical properties of saphenous vein segments. DESIGN Biomechanical properties of 72 saphenous vein segments remaining from coronary bypass grafting of 32 patients have been studied after different storage procedures. MATERIALS The materials studied included fresh segments, segments stored in a cooled conventional physiological salt solution (normal Krebs-Ringer (nKR)) for 1-2 weeks, segments stored in a cooled chemically defined TCM (X-Vivo) for 1,2,3 and 4 weeks and segments cryopreserved for a few weeks. METHODS Specimens were cannulated at both ends and pressure-diameter curves were recorded in the 0-85-mmHg range in nKR with 10 microM norepinephrine added to induce maximum smooth muscle contraction, as well as in Ca(2+)-free medium to induce full relaxation. Tensile strength was checked at 300 mmHg. Distensibility, elastic modulus and active strain were computed. RESULTS Segments stored in nKR dilated morphologically, their distensibility decreased and they lost their ability to contract (1.5+/-0.7% from 10.1+/-1.5% of control) in 1 week. The TCM-stored segments preserved their contractility until 1 week, and this parameter only slowly decreased afterwards (first week, 11.5+/-7.3%; fourth week, 3.9+/-0.6%). There was a slight decrease in wall thickness but the lumen diameter was not affected. The elastic parameters of these segments were practically identical to those of fresh segments. Cryopreserved segments narrowed morphologically, their wall thickened and contractility diminished. CONCLUSIONS Storage in TCM helps preserve the passive and active biomechanical properties of human saphenous vein segments. Such properties can be expected to improve graft tissue viability.
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Affiliation(s)
- G F Molnár
- Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary
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Sax B, Nagy A, Toma I, Rusvai M, Barát E, Huszár E, Kékesi V, Juhász-Nagy A. The pericardial space: a new possible route for influencing cardiac activity. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nagy G, Dzsinich C, Selmeci L, Sepa G, Dzsinich M, Kékesi V, Juhász-Nagy A. Biochemical alterations in cerebrospinal fluid during thoracoabdominal aortic cross-clamping in dogs. Ann Vasc Surg 2002; 16:436-41. [PMID: 12089629 DOI: 10.1007/s10016-001-0037-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Spinal cord damage during and after thoracoabdominal aortic cross-clamping continues to be a major problem. Somatosensory and motor evoked potentials have been used to monitor spinal cord function but their value for predicting paraplegia has been controversial. The aim of this study was to measure biochemical markers in the cerebrospinal fluid (CSF) and correlate changes with spinal cord ischemia. Since neural tissue utilizes only glucose as substrate for its metabolism and energy supply, we measured changes of metabolites of anaerobe glycolysis. In a canine model in which general anesthesia was used, the thoracoabdominal aorta was cross-clamped proximally and distally for 60 min. Hemodynamic parameters, blood gases, and glucose level were monitored continuously. Blood and CSF sampling were performed at baseline, at 15, 30, and 55 min during cross-clamping, and at 5 and 15 min after aortic declamping. Levels of lactate (1.7 +/- 0.1 to 3.2 +/- 0.3 mmol/L), pCO2 (43 +/- 2 to 35 +/- 1.6 mmHg), and neuron-specific enolase (NSE) (5.17 +/- 0.5 to 13.0 +/- 3.5 mg/L) in CSF showed significant changes (p < 0.05) during clamping and reperfusion. Changes in CSF lactate and NSE levels correlate with the duration of spinal cord ischemia. These markers of ischemic metabolism appear suitable to monitor the degree of spinal cord ischemia during thoracoabdominal cross-clamping and may be useful to predict the efficacy of preventive methods.
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Affiliation(s)
- G Nagy
- Department of Cardiovascular Surgery, Semmelweis University Budapest, Budapest, Hungary
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Fazekas L, Kékesi V, Soós P, Barát E, Huszár E, Juhász-Nagy A. Coronary metabolic adaptation restricted by endothelin in the dog heart. Acta Physiol Hung 2002; 88:35-46. [PMID: 11811845 DOI: 10.1556/aphysiol.88.2001.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Endothelin elicits long-lasting vasoconstriction in the coronary bed. This remarkable spastic response raises the question whether or not the metabolic adaptive mechanisms of the coronaries are activated under endothelin effect. The role of the compensatory mediators adenosine and inosine was investigated before and after intracoronary (i.c.) administration of endothelin-1 (ET-1, 1.0 nmol) using 1-min reactive hyperemia (RH) tests on in situ dog hearts (n=15) with or without blocking the ATP-sensitive potassium (K+(ATP)) channels by glibenclamide (GLIB, 1.0 micromol min(-1), i.c.). The release of adenosine and inosine via the coronary sinus was measured by HPLC during the first minute of RH. Endothelin-1 reduced baseline coronary blood flow (CBF) and RH response (hyperemic excess flow (EF) control vs. ET-1: 81.7+/-13.6 vs. 43.4+/-10.9 ml, P<0.01), while it increased the net nucleoside release (adenosine, control vs. ET-1: 58.9+/-20.4 vs. 113.7+/-39.4 nmol, P<0.05; inosine: 242.1+/-81.8 vs. 786.9+/-190.8 nmol, P<0.05). GLIB treatment alone did not change baseline CBF but also reduced RH significantly and increased nucleoside release (EF control vs. GLIB: 72.1+/-11.7 vs. 31.9+/-5.5 ml, P<0.01; adenosine: 18.8+/-4.6 vs. 63.0+/-24.8 nmol, P<0.05; inosine: 113.0+/-37.2 vs. 328.2+/-127.5 nmol, P<0.05). Endothelin-1 on GLIB-treated coronaries further diminished RH and increased nucleoside release (EF: 21.5+/-8.0 ml, P<0.05 vs. GLIB; adenosine: 75.3+/-28.1 nmol, NS; inosine: 801.9+/-196.6 nmol, P<0.05 vs. GLIB). The data show that ET-1 reduces metabolic adaptive capacity of the coronaries, and this phenomenon is due to decreased vascular responsiveness and not to the blockade of ischemic mediator release from the myocardium. The coronary effect of ET-1 may partially be dependent on K+(ATP) channels.
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Affiliation(s)
- L Fazekas
- Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary
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Gelléri D, Kékesi V, Juhász-Nagy S. Is it possible to estimate the pressure's change of the right atrium in arrhythmias from jugular venous pulse tracing (JVPT)? J Mol Cell Cardiol 2002. [DOI: 10.1016/s0022-2828(02)90823-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kékesi V, Toma I, Nagy A, Rusvai M, Barát E, Huszár É, Juhász-Nagy A. Pericardial effects of catecholamines on cardiovascular function and pericardial endothelin-1 and adenine nucleoside levels. J Mol Cell Cardiol 2002. [DOI: 10.1016/s0022-2828(02)90854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Horkay F, Gellér L, Kiss O, Szabó T, Vagó H, Kékesi V, Juhász-Nagy A, Merkely B. Bosentan the mixed endothelin-A- and -B-receptor antagonist suppresses intrapericardial endothelin-1-induced ventricular arrhythmias. J Cardiovasc Pharmacol 2000; 36:S320-2. [PMID: 11078409 DOI: 10.1097/00005344-200036051-00093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In earlier studies severe ventricular arrhythmias developed during intrapericardial (i.p.) endothelin-1 (ET-1) infusion. Monophasic action potential duration (MAPD90) increase and significant ST segment elevation preceded the onset of arrhythmias. The aim of this study was to test the antiarrhythmic and anti-ischemic efficacy of the mixed endothelin-A- and -B- (ETA/B) receptor antagonist bosentan (BOS) on ET-1-induced arrhythmias on six mongrel dogs. Ten minutes after an intravenous bolus dose of BOS (10 mg/kg), ET-1 (33 pmol/kg/min) was given into the pericardial space for 30min (BOS group). Six control dogs received only ET-1 infusion (control group). Mean arterial blood pressure (MAP), cardiac output, electrocardiograph (ECG), right and left ventricular endo- and epicardial (RVEND, RVEP, LVEND, LVEP) MAPD90s were recorded. MAP and cardiac output did not change significantly in the BOS group. Significant MAPD90 prolongation was found in all investigated regions of the control group (ET start vs ET 20 min: LVEP, 174 +/- 3 vs 208 +/- 10*; RVEND, 206 +/- 9 vs 241 +/- 12* ms, *p < 0.05), while significant MAPD90 alterations were not observed in the BOS group (basic vs ET 20 min: RVEP, 189 +/- 5 vs 196 +/- 5; LVEP, 199 +/- 5 vs 199 +/- 4; RVEND, 194 +/- 5 vs 195 +/- 6; LVEND, 209 +/- 3 vs 213 +/- 5 ms). Early after depolarizations (EADs) were observed in three control dogs. Severe ventricular arrhythmias [incessant nonsustained ventricular tachycardias (nsVTs) in all cases, sustained VTs (sVTs) in four, ventricular fibrillation (VF) in two instances] were present in the control group, whereas nsVTs were observed only in two dogs in the BOS group. ST segment elevation was more pronounced in the control group than in the BOS group (1.01 +/- 0.2 vs 0.41 +/- 0.07 mV, p < 0.05). In summary, bosentan effectively inhibits intrapericardial ET- 1-induced ventricular arrhythmias, moreover it may have a protective effect against epimyocardial ischemia.
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Affiliation(s)
- F Horkay
- Department of Cardiovascular Surgery, Semmelweis Medical University, Budapest, Hungary.
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Fazekas L, Soós P, Fazekas R, Kékesi V, Juhász-Nagy A. Role of K+ATP channels in the metabolic adaptation of the coronaries. Adv Exp Med Biol 2000; 471:239-45. [PMID: 10659153 DOI: 10.1007/978-1-4615-4717-4_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- L Fazekas
- Department of Cardiovascular Surgery, Semmelweis University of Medicine, Budapest, Hungary
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Affiliation(s)
- A Juhász-Nagy
- Department of Cardiovascular Surgery, Semmelweis University of Medicine, Budapest, Hungary
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Dzsinich C, Nagy G, Selmeci L, Sepa G, Fazekas L, Kékesi V, Juhász-Nagy S. [Effect of regional hypothermia on cerebrospinal fluid parameters during thoracoabdominal aorta clamping in dogs]. Magy Seb 2000; 53:79-84. [PMID: 11299626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The most feared complication of thoracoabdominal clamping is the paraplegia or paraparesis following ischemic injury of the spinal cord. Early intraoperative recognition of this complication has not been solved yet. In our earlier experiment we found significant alterations of CSF glucose, lactate, pCO2 and Neuron Specific Enolase (NSE) levels during 60 minutes thoracoabdominal aortic clamping in dogs. The analysis of these parameters proved to be proper to follow metabolism of the spinal cord during this type of surgery. In our present paper we studied protective effect of regional hypothermia using peridural cooling by registration of above parameters. Statistical analysis of our data showed prevention of production of anaerobe metabolites in animals with icy peridural irrigation. The biochemical approach is appropriate for monitoring effectiveness of regional hypothermia of the spinal cord during aortic surgery.
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Affiliation(s)
- C Dzsinich
- Semmelweis Egyetem Budapest Altalános Orvostudományi Kar Er- és Szívsebészeti Klinika, Budapest
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Fazekas L, Horkay F, Kékesi V, Huszár E, Barát E, Fazekas R, Szabó T, Juhász-Nagy A, Naszlady A. Enhanced accumulation of pericardial fluid adenosine and inosine in patients with coronary artery disease. Life Sci 1999; 65:1005-12. [PMID: 10499868 DOI: 10.1016/s0024-3205(99)00331-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Adenosine and inosine are believed to have cardioprotective effects. However, little is known about their possible role in the metabolic autoregulation of human coronaries and in pathologic conditions with supply/demand imbalance of the heart such as coronary artery disease. Since these low molecular weight nucleosides freely diffuse through the monolayer of the visceral pericardium, adenosine and inosine concentrations in pericardial fluid may well reflect the conditions in cardiac interstitium. The pericardial fluid and systemic venous blood adenosine and inosine concentrations were measured in 98 human subjects undergoing heart surgery for coronary artery disease or valvular heart disease. Adenosine and inosine concentrations were measured by HPLC with UV detection. In subjects with coronary artery disease pericardial fluid nucleoside concentrations were significantly higher than in patients with valvular heart disease (adenosine: 1545 (996-3146) nmol/L [median (25th-75th quartiles)] vs. 738 (390-2527) nmol/L, P<0.01; inosine: 658 (321-1331) nmol/L vs. 347 (159-1037) nmol/L, P<0.05), while in both patient groups pericardial fluid nucleoside concentrations were higher by an order of magnitude than in venous plasma. Our results show the enhanced release of adenosine and inosine by the ischemic myocardium as a marker of supply/demand imbalance and support the hypothesis that these cardiac nucleosides may have an important role in the adaptation of coronary blood flow in human coronary artery disease.
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Affiliation(s)
- L Fazekas
- Department of Cardiovascular Surgery, Semmelweis University of Medicine, Budapest, Hungary.
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Kiss P, Horváth I, Szokodi I, Tóth P, Kékesi V, Juhász-Nagy A, Tóth M. Endothelin does not interact with angiotensin II in the coronary vascular bed of anesthetized dogs. J Cardiovasc Pharmacol 1998; 31 Suppl 1:S103-5. [PMID: 9595412 DOI: 10.1097/00005344-199800001-00031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We postulated that individually subthreshold circulating levels of angiotension II (Ang II) and endothelin-1 (ET-1) might induce fulminant coronary vasoconstriction when both are present. In 16 pentobarbital-anesthetized, open-chest mongrel dogs, blood pressure, heart rate, and standard ECG were registered continuously. Coronary blood flow (CBF) was measured in the left anterior descending coronary artery (LAD) by an electromagnetic flow probe. Drugs were administered into the LAD via an indwelling catheter. Bolus injections of Ang II (7.8 x 10(-13) to 3.9 x 10(-11) M) and ET-1 (10(-12) to 10(-9) M) induced a dose-dependent decrease in CBF (delta CBFmax -82 +/- 10% for Ang II and -91 +/- 8% for ET-1). Simultaneous Ang II and ET-1 boluses had slightly smaller effects on CBF than the calculated additive figure. Five-minute infusions of Ang II (10(-12) to 10(-10) M/min) and ET-1 (5 x 10(-12) to 2 x 10(-10) M/min) induced a slight decrease in CBF (delta CBFmax -12 +/- 9% for Ang II and -19 +/- 9% for ET). Background ET-1 or Ang II infusions did not alter the dose-response curve of the other drug. Simultaneous Ang II and ET-1 infusions at different rates (10(-12) to 10(-10) M/min for Ang II and 5 x 10(-12) to 2 x 10(-10) M/min for ET-1) over 5 min had similar effects on CBF as the calculated additive figure (delta CBFmax -35 +/- 17% for the joint administration of the highest doses). We conclude that after simultaneous administration into the dog coronary artery, Ang II and ET-1 do not interact sufficiently to induce fulminant vasoconstriction.
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Affiliation(s)
- P Kiss
- Department of Medicine and Cardiovascular Surgical Clinic, Semmelweis University, Budapest, Hungary
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Horkay F, Szokodi I, Merkely B, Solti F, Gellér L, Kiss P, Selmeci L, Horváth I, Kékesi V, Juhász-Nagy A, Tóth M. Potential pathophysiologic role of endothelin-1 in canine pericardial fluid. J Cardiovasc Pharmacol 1998; 31 Suppl 1:S401-2. [PMID: 9595496 DOI: 10.1097/00005344-199800001-00115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Recently, extremely high levels of endothelin-1 (ET-1) were detected in the pericardial fluid of patients undergoing cardiac surgery. This study was designed to assess the pathophysiologic importance of this finding by infusing ET-1 into the closed pericardial sac of anesthetized dogs. Systemic arterial blood pressure, heart rate, and standard ECG were recorded. Intrapericardial infusion of ET-1 (11 and 33 pmol/kg/min; n = 4/4) for 40 min induced ventricular arrhythmias in all instances. The lower dose of ET-1 induced a substantial number of ventricular extrasystoles, couplets, and triplets. In one instance, ventricular extrasystoles accelerated into nonsustained ventricular tachycardia (VT). In animals receiving the higher dose, nonsustained VTs occurred regularly, whereas sustained VTs were detected in two of four animals. Before the onset of arrhythmias, QT time was significantly prolonged [ET-1 (11 pmol/kg/min) 180 +/- 12 to 198 +/- 10 ms, p < 0.05; ET-1 (33 pmol/kg/min) 192 +/- 15 to 233 +/- 13 ms, p < 0.01]. Hemodynamic variables did not change significantly before the onset of ventricular arrhythmias. Our results show that administration of exogenous ET-1 into the pericardial space induces ventricular arrhythmias associated with prolongation of QT time.
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Affiliation(s)
- F Horkay
- Department of Cardiovascular Surgery, Semmelweis University Medical School, Budapest, Hungary
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Abstract
In a previous study we established that endothelin-1 (ET-1) can induce characteristic ventricular tachycardias (VT) with significant prolongation of QT and QTc time. In this investigation we studied the role of CA2+ channels in the pro-arrhythmic effects of ET-1. In 24 anesthetized, open-chest mongrel dogs, ET-1 was administered into the left anterior descending coronary artery at a comparatively low dose (60 pmol/min) for 30 min. Twelve dogs received the Ca(2+)-channel blocker verapamil (0.4 mg/kg) before ET-1 application. The following parameters were recorded continuously over the infusion period: systemic arterial blood pressure, coronary blood flow, surface ECG leads, epicardial atrial and ventricular electrograms, and right and left ventricular endocardial monophasic action potentials (MAP). Electrophysiologic studies were performed by programmed electrical stimulation of the heart. Blockade of myocardial Ca2+ channels attenuated the arrhythmogenic action of ET-1. After verapamil administration to ET-1-treated dogs, sustained VT did not appear and ventricular fibrillation (VF) developed only in two dogs. In the control group serious and sustained VT and VF developed in nine animals. It is noteworthy that verapamil did not prevent ET-1-induced prolongation of QT time. The results appear to prove that myocardial Ca2+ channels are involved in the proarrhythmic effect of ET-1.
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Affiliation(s)
- F Solti
- Department of Cardiovascular Surgery, Semmelweis University Medical School, Budapest, Hungary
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Merkely B, Gellér L, Tóth M, Kiss O, Kékesi V, Solti F, Vecsey T, Horkay F, Tenczer J, Juhász-Nagy A. Mechanism of endothelin-induced malignant ventricular arrhythmias in dogs. J Cardiovasc Pharmacol 1998; 31 Suppl 1:S437-9. [PMID: 9595506 DOI: 10.1097/00005344-199800001-00125] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The development of ventricular tachyarrhythmias caused by low-dose intracoronary infusion of endothelin-1 (ET-1) has recently been observed in dogs. The aim of the present study was to investigate the pathomechanism of ET-1-induced ventricular arrhythmias in 32 anesthetized, open-chest mongrel dogs in group A (n = 14) without, in group B (n = 14), and in group C (n = 4 control) with atrioventricular node ablation. The coronary blood flow (CBF) was measured in the left anterior descending (LAD) coronary artery by an electromagnetic flowmeter. Standard ECG, atrial and ventricular electrograms, and in groups B and C endocardial and epicardial monophasic action potentials (MAPs) were recorded. ET-1 was administered into the LAD at a low dose (30-60 pmol/min). At the time of the appearance of premature beats, CBF was only slightly decreased. The effective ventricular refractory period did not change significantly. Onset of spontaneous polymorphic and monomorphic sustained ventricular tachycardia (sVT) was observed in five dogs without bradycardia and in nine dogs with bradycardia. VTs in dogs with complete AV block were longer and slower. In most of the cases, ventricular fibrillation occurred. ET-1 treatment resulted in a significant increase in MAP 90% duration (255 +/- 9 vs. 290 +/- 8 ms endocardial, 244 +/- 10 vs. 292 +/- 12 epicardial; p < 0.05) at 70 beats/min ventricular pacing. In eight cases (group B), third-phase early afterdepolarization could be recorded. According to our results, the mechanism of ET-1-induced arrhythmias appears to be based on prolongation of MAP duration and development of afterdepolarizations.
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Affiliation(s)
- B Merkely
- Department of Cardiovascular Surgery, Semmelweis Medical University, Budapest, Hungary
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Abstract
The effect of permanent bradycardia on the proarrhythmic action of endothelin-1 (ET) was investigated in 24 open-chest anesthetized mongrel dogs. In 12 dogs, permanent bradycardia was induced by radiofrequency ablation of the AV node and the hearts were paced at 70 beats/min. ET (60 pmol/min) was infused into the left anterior descending coronary artery. Blood pressure, coronary blood flow (CBF), and atrial and ventricular epicardial surface ECG were recorded continuously. Polymorphous ventricular tachycardia developed in every dog with permanent bradycardia, and ventricular fibrillation terminated the experiments in 11 cases. Bradycardia prolonged the basal QT but there was no difference in the frequency corrected QTc time between the two groups. ET prolonged the QT time in a similar fashion in both groups. In the control group, six dogs developed sustained ventricular tachycardias and ventricular fibrillation occurred in nine cases. EADP was found in six cases of eight registered. Signs of myocardial ischemia did not accompany the development of arrhythmias. We conclude that permanent bradycardia augments the direct proarrhythmic effect of ET in dogs.
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Affiliation(s)
- M Tóth
- First Department of Medicine, Semmelweis University, Budapest, Hungary
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Gellér L, Merkely B, Lang V, Szabó T, Fazekas L, Kékesi V, Kiss O, Horkay F, Schaldach M, Tóth M, Juhász-Nagy A. Increased monophasic action potential dispersion in endothelin-1-induced ventricular arrhythmias. J Cardiovasc Pharmacol 1998; 31 Suppl 1:S434-6. [PMID: 9595505 DOI: 10.1097/00005344-199800001-00124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this study was to investigate the changes in monophasic action potentials (MAP) from different sites in the heart and to determine MAP dispersion during endothelin-1 (ET-1) infusion. Standard ECG, left ventricular anterior, right ventricular lateral, right ventricular septal, and right ventricular apical MAPs and intra-arterial blood pressure were monitored in seven anesthetized open-chest mongrel dogs. After radiofrequency atrioventricular node ablation, ventricular pacing (70/min) was performed and intracoronary ET-1 (60 pmol/min) was administered into the left anterior descending coronary artery. Both MAPd90 and MAPd90 dispersion increased significant during ET-1 infusion. The onset of spontaneous monomorphic and polymorphic sustained ventricular tachycardias (sVT) was observed in five dogs (around 40 min), and nonsustained VTs (nsVT) developed in another two dogs. The increases in MAP and MAP dispersion lasted until the appearance of polymorphic nsVTs and sVTs, but at the time of these VTs this difference decreased. At the termination of the experiments, ventricular fibrillation occurred in six cases. In four cases third-phase early afterdepolarizations were recorded. Our results suggest that increased MAP dispersion and development of EAD contribute to the arrhythmogenic action of ET-1, and these phenomena might explain the pathogenesis of a wide variety of ventricular arrhythmias with different morphology observed in this study.
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Affiliation(s)
- L Gellér
- Department of Cardiovascular Surgery, Semmelweis Medical University, Budapest, Hungary
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19
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Abstract
The vasodilator capacity of the coronaries was determined by the reactive hyperemia (RH) test in open-chest anesthetized dogs. The myocardial release of adenine nucleosides (adenosine and inosine) was measured by the HPLC-UV method. In group I (n = 9) after the control RH test, a bolus injection of endothelin-1 (ET-1; 1.0 nmol i.c.) was administered and was followed by a second RH test. In group II (n = 9), glibenclamide (GLIB) was infused continuously (1.0 mumol/min i.c.) and RH tests were performed during the control period and then before and after bolus injection of ET-1. In contrast to the significant reduction of the RH response after ET-1 in group I and after GLIB in group II, the nucleoside release into the coronary sinus during the first minute of the RH test was significantly higher (adenosine release 0.05 +/- 0.02 vs. 0.10 +/- 0.04 mumol, and 0.02 +/- 0.00 vs. 0.08 +/- 0.02 mumol; p < 0.05). Injection of ET-1 did not result in further RH reduction in GLIB-pretreated dogs (group II) but significantly increased nucleoside release. High doses of ET-1 activated the metabolic compensatory mechanisms of the myocardium and thereby increased the release of adenine nucleosides into the venous blood of the heart. However, whether these metabolites can exert any significant compensatory vasodilator effects appears doubtful.
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Affiliation(s)
- L Fazekas
- Department of Cardiovascular Surgery, Semmelweis University of Medicine, Budapest, Hungary
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20
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Szokodi I, Horkay F, Merkely B, Solti F, Gellér L, Kiss P, Selmeci L, Kékesi V, Vuolteenaho O, Ruskoaho H, Juhász-Nagy A, Tóth M. Intrapericardial infusion of endothelin-1 induces ventricular arrhythmias in dogs. Cardiovasc Res 1998; 38:356-64. [PMID: 9709396 DOI: 10.1016/s0008-6363(98)00018-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Recently, extremely high levels of endothelin-1 (ET-1) were detected in the pericardial fluid of patients with heart disease; however, the pathophysiological importance of this finding is not known. The present study was designed to characterize ET-1 levels in canine pericardial fluid and to investigate the effects of local high concentrations of exogenous ET-1 in vivo. METHODS In anesthetized, open-chest dogs ET-1 (Groups 1 and 2: 11 and 33 pmol.kg-1.min-1; n = 6 and 6, respectively) or physiological saline (Group 3, n = 5) were infused into the closed pericardial sac for 40 min. In serial pericardial fluid and aortic blood plasma samples, ET-1 levels were measured by radioimmunoassay, and analysed by high-performance liquid chromatography (HPLC). Systemic arterial blood pressure, heart rate, cardiac output (CO), standard ECG and right ventricular endocardial monophasic action potentials (MAPs) were recorded. RESULTS Basal pericardial fluid ET-1 levels were significantly higher than respective plasma levels (342 +/- 210 vs. 8.0 +/- 5.2 pmol.l-1, n = 14, P < 0.001. In HPLC analysis pericardial fluid ET-1 was indistinguishable from ET-1(1-21). Infusion of exogenous ET-1 into the pericardial space induced ventricular arrhythmias in all instances, which were associated with 9.7-fold increase in pericardial fluid ET-1 levels. Ventricular tachycardias developed in 9 of 12 animals. The arrhythmogenic effect of ET-1 was more apparent in dogs with the larger dose. Before the onset of arrhythmias, intrapericardial infusion of ET-1 increased QT time (Group 1: 207 +/- 18 to 230 +/- 23 ms, P < 0.01; Group 2: 220 +/- 12 to 277 +/- 17 ms, P < 0.01) and MAP duration at 90% repolarization (at 300 ms cycle length) (Group 1: 192 +/- 9 to 216 +/- 9 ms, P < 0.01; Group 2: 205 +/- 9 to 255 +/- 9 ms, P < 0.001). Hemodynamic variables did not change significantly prior to the onset of ventricular tachyarrhythmias. In Group 3, arrhythmias were not observed and all electrophysiological and hemodynamic parameters remained unchanged. CONCLUSIONS Administration of exogenous ET-1 into the pericardial space induces ventricular arrhythmias associated with prolongation of QT time and MAP duration. Whether pericardial fluid ET-1 under pathophysiological conditions can ever reach sufficiently high levels to induce ventricular arrhythmias remains to be elucidated.
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Affiliation(s)
- I Szokodi
- Department of Cardiovascular Surgery, Semmelweis University of Medicine, Budapest, Hungary.
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21
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Horkay F, Szokodi I, Selmeci L, Merkely B, Kékesi V, Vecsey T, Vuolteenaho O, Ruskoaho H, Juhász-Nagy A, Tóth M. Presence of immunoreactive endothelin-1 and atrial natriuretic peptide in human pericardial fluid. Life Sci 1998; 62:267-74. [PMID: 9488105 DOI: 10.1016/s0024-3205(97)01105-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study was undertaken to characterize endothelin-1 (ET-1) and atrial natriuretic peptide (ANP) concentrations in human pericardial fluid, blood plasma, right atrial appendage and papillary muscle by use of specific radioimmunoassays. In patients undergoing cardiac surgery (n=16) pericardial fluid mean immunoreactive (ir-) ET-1 and ir-ANP levels were 36-fold and 4-fold higher than corresponding plasma levels, respectively. In high performance liquid chromatography (HPLC) pericardial fluid ir-ET-1 was indistinguishable from human ET-1[1-21] and the majority of pericardial fluid ir-ANP coeluted with human ANP[99-126]. Atrial tissue ir-ET-1 and ir-ANP concentrations were 17-fold and 870-fold higher than in ventricular tissue. Our present study demonstrated for the first time the presence of ir-ET-1 in the pericardial fluid in humans. Human pericardial fluid contained far the highest concentrations of ET-1 among all biological fluids tested thus far. The functions of pericardial fluid ET-1 and ANP on cardiac performance and coronary vascular tone require further investigations.
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Affiliation(s)
- F Horkay
- Department of Cardiovascular Surgery, Semmelweis University of Medicine, Budapest, Hungary
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22
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Szokodi I, Horkay F, Kiss P, Selmeci L, Merkely B, Kékesi V, Vuolteenaho O, Leppäluoto J, Ruskoaho H, Juhász-Nagy A, Tóth M. Characterization and stimuli for production of pericardial fluid atrial natriuretic peptide in dogs. Life Sci 1997; 61:1349-59. [PMID: 9335224 DOI: 10.1016/s0024-3205(97)00680-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recently high immunoreactive atrial natriuretic peptide (ir-ANP) levels have been found in the pericardial fluid of patients undergoing cardiac surgery. The present study was designed to characterize pericardial fluid ANP in anesthetized dogs. Pericardial fluid ir-ANP levels were 3.4-fold higher than plasma levels and the molecular form, revealed by high performance liquid chromatography, was indistinguishable from ANP[99-126]. Elimination of [125I]ANP was 5-fold slower in the pericardial space than in plasma. Activity of the major ANP degrading enzyme, neutral endopeptidase (NEP, EC 3.4.24.11), was 15-times higher in the pericardial fluid than in plasma. Right atrial balloon distension and rapid right ventricular pacing induced maximally 2.3-fold and 1.5-fold increases of pericardial fluid ir-ANP, respectively. Pericardial fluid ir-ANP concentrations and right atrial pressure values showed significant correlation during the stimuli. Our present results show that high concentrations of ir-ANP can be found in the dog pericardial fluid even under unstimulated conditions. Slow elimination of ANP from the pericardial fluid compartment may contribute to the high peptide levels. However this slow elimination cannot be attributed to a lower NEP activity. High basal levels of ANP in the pericardial fluid could be further increased by atrial balloon stretch and rapid ventricular pacing. The increase of pericardial fluid ir-ANP appeared to be a stretch-dependent response. ANP released into the pericardial fluid may be involved in the regulation of cardiac function and coronary vascular tone.
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Affiliation(s)
- I Szokodi
- Department of Cardiovascular Surgery, Semmelweis University Medical School, Budapest, Hungary.
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23
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Abstract
Recently, effects of somatostatin on the renal function have been described and the vasoactive properties of the peptide were proposed to contribute to this action. However, the available data on its effect in the renal vascular bed are very controversial. Therefore, we investigated the effect of local intaarterial somatostatin boluses in a wide range of doses (5 x 10(-11) - 5 x 10(-5) g) on the renal blood flow (RBF) in anesthetized dogs. RBF was measured by an electromagnetic flow probe. Somatostatin did not influence blood pressure or heart rate. RBF exhibited a significant, dose-dependent fall (ranging from 11.6 +/- 11.9% to 31.9 +/- 17.3%), with a threshold at a dose of 5 x 10(-10) g. These results offer conclusive evidence for the contribution of somatostatin-induced direct renal vasoconstriction to its renal effects, in addition to the demonstrated modulation of other vasoactive systems and tubular functions.
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Affiliation(s)
- P Tóth-Heyn
- First Department of Pediatrics, Semmelweis University Medical School, Budapest, Hungary
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24
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Solti F, Lengyel E, Jellinek H, Schneider F, Juhász-Nagy A, Kékesi V. Coronary arteriopathy after lymphatic blockade: an experimental study in dogs. Lymphology 1994; 27:173-80. [PMID: 7898131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The effects of lymph stasis on the histological and biochemical properties of the coronary arterial wall and on the coronary circulation were studied in 72 dogs. Cardiac lymph stasis was produced in 52 dogs by cardiac lymphatic blockade whereas in 20 dogs only a sham operation was performed. Blockade of cardiac lymph drainage promoted characteristic injury to the coronary arteries including subendothelial edema with plasma inbibition, interstitial and intracellular edema in the tunica media with degeneration in the smooth muscle layer, swelling of the adventitial space with dilated lymph vessels and, later, fibrosis. The biochemical properties of the coronary arterial wall also were adversely affected by cardiac lymph stasis. Thus, the collagen and hexosamine content of the coronary arteries increased and the metabolism of the coronary wall shifted in an anaerobic direction. Whereas coronary blood flow was slightly decreased with lymph blockade, the coronary circulatory reserve capacity and the adaptability of the coronary vascular system was markedly reduced. The histological changes were most apparent in the smaller coronary arteries. The coronary microvasculature was also pathologically altered with the development of numerous coronary arteriovenous microshunts. These findings in conjunction with other experimental and clinical information suggest that impaired cardiac lymph drainage contributes to the pathogenesis and progression of coronary artery disease.
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Affiliation(s)
- F Solti
- Cardiovascular Surgical Clinic, Semmelweis Medical University, Budapest, Hungary
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25
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Abstract
The aim of the study was to investigate the pathological role of free radicals during myocardial reperfusion. Low (0.5 mg/kg body weight) and high doses (5 mg/kg) of superoxide dismutase (SOD) were infused into the left atrium of mongrel dogs for 4 min starting 29 min after ligation and 1 min before reperfusion of the left anterior descending coronary artery (LAD). Arterial blood pressure, heart rate, electrocardiogram, and the regional contractile force of the left ventricle were monitored throughout the ligation (30 min) and reperfusion periods (20 min). Concentrations of creatine kinase (CK) and malondialdehyde (MDA) in the coronary sinus blood were determined before (0 min) and during ligation (15 and 25 min) and during reperfusion of the LAD (2, 7, and 20 min). In other groups of dogs, the effect of the two doses of SOD on epicardial blood flow was investigated during ligation and reperfusion by the measurement of epicardial temperature using a thermocardiograph. Experimental subjects were mongrel dogs of either sex (n = 25), weight 10-35 kg. Compared to controls (mean +/- SEM, 43.1 +/- 1.2; n = 7), the number of ventricular extrasystoles during the first 5 min of reperfusion was significantly (p < .001) decreased in dogs treated with the high dose (15.01 +/- 2.14; n = 5), but not in those receiving the low dose of the drug (34.6 +/- 5.66; n = 5). The concentrations of CK increased gradually until the end of reperfusion without differences among the different groups. Plasma MDA was the highest in control dogs 7 min after reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- L Kónya
- Second Department of Medicine, Semmelweis University, Budapest, Hungary
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26
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Solti F, Kékesi V, Juhász-Nagy A. The effect of atrial dilatation on reperfusion arrhythmias: development of supraventricular tachycardias on reperfusion with atrial stretching. Acta Med Hung 1992; 49:159-70. [PMID: 1345453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
UNLABELLED The study was aimed at investigating the effect of atrial dilatation on the genesis of supraventricular tachyarrhythmias following myocardial reperfusion. Experiments were carried out in 26 mongrel dogs under pentobarbital narcosis with artificial ventilation. Electrophysiological study was performed for studying the arrhythmic condition of the heart. Investigations were carried out: (i) in normal condition, (ii) during atrial stretching (balloon dilatation of the left atrium), (iii) in reperfusion following myocardial ischemia, (iv) in reperfusion combined with atrial stretching. On reperfusion the irritability of the atrium increased moderately (on atrial extrastimuli in 3 dogs non-sustained atrial tachycardia, in 7 dogs repeated atrial responses could be induced). Reperfusion with atrial stretching, however, very markedly enhanced the atrial vulnerability, and in 19 dogs atrial tachycardia appeared spontaneously. Comparison of the effect of atrial stretching to that of atrial stretching + reperfusion showed that the reperfusion significantly augmented the arrhythmia-inducing effect of atrial stretching. CLINICAL INVESTIGATIONS Aortocoronary bypass operations were followed by development of supraventricular tachycardia in 41 out of 428 operated cases. Atrial dilatation was detected in 37 cases, mostly before the appearance of atrial tachycardia. The data seem to prove that atrial dilatation has an important part in the pathogenesis of supraventricular tachyarrhythmias following reperfusion of myocardial ischemia.
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Affiliation(s)
- F Solti
- Cardiovascular Surgical Clinic, Semmelweis University Medical School, Budapest, Hungary
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27
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Solti F, Jellinek H, Schneider F, Lengyel E, Bérczi V, Kékesi V. Lymphatic arteriopathy: damage to the wall of the canine femoral artery after lymphatic blockade. Lymphology 1991; 24:54-9. [PMID: 1921476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The effect of lymph stasis on the histological, biochemical, and elastic properties of the femoral artery were studied after regional lymphatic blockade in 36 dogs. Dogs were sacrificed 4-21 days after operation. Histologic changes of the femoral arterial wall (interstitial edema, degeneration in the muscle layer or media, thickened adventitia with dilated lymph vessels, and fibrosis) developed after regional lymphatic blockade. Characteristic metabolic alterations of the arterial wall (anaerobic catabolism of carbohydrate, increased lactate and glycosamine content) accompanied the morphological changes. Distensibility of the femoral artery decreased and greater elastic stiffness developed after regional lymphatic blockade. These results in conjunction with other experimental and clinical data support the concept that insufficient lymphatic transport within the blood vessel wall may contribute to the genesis and progression of arteriopathies.
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Affiliation(s)
- F Solti
- Cardiovascular Surgical Clinic, Semmelweis Medical University, Budapest, Hungary
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28
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Papp L, Kékesi V. Augmented coronary sinus pressure does affect coronary autoregulation. J Thorac Cardiovasc Surg 1989; 98:634-6. [PMID: 2796372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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29
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Abstract
The effect of atrial stretching on the genesis of atrial arrhythmias was studied in 26 dogs. Left atrial dilatation was produced by inflation of a balloon catheter. Electrophysiological studies were performed by programmed electrical stimulation of the atrium and ventricle. The irritability of the atrium markedly increased when it was distended and atrial arrhythmias (sustained or non-sustained atrial tachyarrhythmias) could regularly be induced by administration of an early extrastimulus or--more rarely--by atrial burst pacing. In 10 cases spontaneous atrial tachycardia appeared during atrial balloon dilatation. The atrial effective refractory period shortened and the atrial conduction time lengthened on atrial stretching, while other electrical variables (cycle length, sinus node recovery time, atrioventricular conduction time, intraventricular conduction, ventricular refractory period, QT interval) remained unchanged. Atrial balloon dilatation was not accompanied by marked haemodynamic changes, and the left ventricular pressure curve, the contractility of the left ventricle and the central venous pressure did not change significantly on atrial stretching. The experimental data suggest that the atrial dilatation plays an important part in the pathogenesis of atrial arrhythmias.
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Affiliation(s)
- F Solti
- Cardiovascular Surgical Clinic, Budapest, Hungary
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30
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Kollár A, Kékesi V, Juhász-Nagy A. The dopamine-induced coronary vasoconstrictor response is potentiated by adenosine administration in the dog heart. Jpn Heart J 1989; 30:709-21. [PMID: 2614933 DOI: 10.1536/ihj.30.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The ineffectiveness of beta-adrenergic blockade in abolishing adenosine-induced coronary vasodilation was utilized to demonstrate that dopamine (DA) is capable of eliciting very strong coronary vasoconstrictor actions in vivo. In 2 separate groups of dogs anesthetized with pentobarbital, responses to DA were assessed either by flowmeter recordings or by computer-aided infrared thermography, which senses coronary blood flow-dependent heat emission from the epicardium. In untreated controls, submaximal DA infusions (16 micrograms.kg-1.min-1 iv) elicited a coronary vasodilator response. The thermographic equivalent of this hemodynamic action was an increased epicardial temperature. Pretreatment with oxprenolol (0.5 mg.kg-1 iv) preserved both basic heart activity and cardiac heat emission at levels which were comparable to the control state, but prevented DA mediated excitation of cardiac and coronary beta-adrenoceptors. In this state, DA infusion constricted the coronary arteries and tended to decrease heart emission. However, both types of effects were moderate, and only the hemodynamic effect was statistically significant. If DA was given after the coronary bed had been dilated submaximally by adenosine (30 micrograms.kg-1.min-1 infused into the left heart), the flow-reducing effect of DA became a dramatic phenomenon, and the DA-induced epicardial cooling was significantly potentiated. The results show that after eliminating conventional beta-effects, DA affects the coronary arteries through vasoconstrictor mechanisms. This finding suggests that the DA-induced constriction is limited in undilated coronary arteries by the metabolic autoregulatory capacity of the vessels.
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Affiliation(s)
- A Kollár
- Department of Cardiovascular Surgery, Semmelweis University Medical School, Budapest, Hungary
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31
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Rabloczky G, Kékesi V, Mader MR, Juhász-Nagy A. Dopamine-induced coronary effects in the dog heart attributed to beta- and alpha-adrenergic mechanisms. Arch Int Pharmacodyn Ther 1988; 293:109-26. [PMID: 2844127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Open chest anesthetized dogs were given dopamine (DA) in intravenous (i.v., 2-16 micrograms.kg-1.min-1) and intracoronary (i.c., 10-40 micrograms.min-1) infusions. The drug effect was analyzed using the nonselective beta-adrenoceptor antagonist oxprenolol (0.5 mg.kg, i.v.) and the nonselective alpha-adrenoceptor antagonist phentolamine (1.0 mg.kg-1, i.v.). Coronary blood flow (CBF, electromagnetic flowmeter), arterial pressure and left ventricular contractile force (strain gauge) were measured. Coronary vascular responses were characterized by changes of CBF and calculated coronary vascular resistance (CVR). In the control state, DA-induced arterial hypertension (i.v. administration) and augmented inotropism (i.v. and i.c. administration) were accompanied by a dose-dependent coronary vasodilatation (increase of CBF and decrease of CVR). Oxprenolol converted coronary vasodilatation to vasoconstriction during DA infusions and blocked the inotropic action; the hypertensive DA effect remained unaffected. Similar alterations were observed after a transitory (45 min) regional myocardial ischemia, elicited by coronary occlusion. On the other hand, phentolamine-pretreatment potentiated the DA-induced coronary vasodilatation and converted hypertension to hypotension; the inotropic component of the DA action was not affected. After combined beta- and alpha-blockade, DA failed to increase CBF and decrease CVR during the infusion periods. Instead, the drug elicited a very slight coronary vasoconstriction. I.c. (but not i.v.) infusions of DA were regularly followed by a rebound-like, transient CBF increase, even after combined beta- and alpha-blockade. These results show that all of the multifactorial determinants of the direct, steady state coronary effects of DA can be ascribed to alpha- and beta-adrenoceptor stimulation, whereas the hypothetical dopaminergic coronary vascular receptors do not seem to play a decisive role in these responses. However, undefined after-effects provoked by i.c. DA, may be connected with specific dopaminergic effects.
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Affiliation(s)
- G Rabloczky
- Institute of Drug Research, Budapest, Hungary
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32
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Kékesi V, Juhász-Nagy A. Pharmacologic assessment of the functional state in stenosed coronary circulation of the dog. Acta Physiol Acad Sci Hung 1982; 59:147-153. [PMID: 7158369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
In open chest dogs under sodium pentobarbital anaesthesia the interaction of mechanical constriction on a large coronary branch and autoregulatory capacity of the relevant small resistance vessels was analyzed. Coronary blood flow (CBF) was measured with an electromagnetic flowmeter. Step-by-step mechanical constriction gradually abolished adenosine-induced coronary vasodilation, whereas the resting level of mean CBF remained unaltered. At this point verapamil (0.2 mg/kg i.v.), a vasodilator with a strong potency of blocking adenosine action, eventually decreased CBF and increased coronary resistance. Similar results were obtained with these drugs injected directly into a bypass established between the carotid and left common coronary arteries. The results suggest that (i) adenosine affects the same coronary segments which accomplish compensatory autoregulation (ii); with critical stenosis verapamil augments indirectly coronary resistance by inhibiting an "intrinsic" adenosine effect (iii); the functional state of stenosed coronaries can be assessed with the aid of these pharmacologic tests.
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