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  • 1
    Electronic Resource
    Electronic Resource
    Effects of Celsior and University of Wisconsin preservation solutions on hemodynamics and endothelial function after cardiac transplantation in humans: a single-center, prospective, randomized trial (2000)
    Springer
    Transplant international 13 (2000), S. S203 
    Details
    ISSN: 1432-2277
    Keywords: Key words Cardiac transplantation ; Myocardial preservation ; Endothelin ; Nitric oxide synthases ; Humans
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Optimal preservation of the myocardium remains a major concern in clinical and experimental heart transplantation. The present study compared the efficacy of University of Wisconsin (UW) and Celsior preservation solution with respect to myocardial performance, epicardial and microvascular endothelial vasomotor function and myocardial expression of endothelin and nitric oxide synthases in humans. Forty-one cardiac transplant recipients received either UW (n = 20) or Celsior (n = 21) preserved hearts. Catecholamine and vasodilator requirements were assessed within the first 5 postoperative days. Left ventricular performance and endothelial function was assessed 1 month after transplantation. Endothelin and nitric oxide synthase gene expression were detected in myocardial biopsy samples. Celsior preserved hearts required significantly more catecholamines and vasodilators within the first 5 postoperative days. Myocardial performance and endothelial function were comparable 1 month after transplantation. Total ischemic time correlated with impaired endothelial function in the Celsior but not in the UW group. Endothelin and inducible nitric oxide synthase gene expression were significantly higher in the Celsior group. The results of the study show that both solutions provide myocardial protection with regard to left ventricular performance and endothelial function 1 month after cardiac transplantation. The necessity for higher vasodilator and catecholamine therapy in Celsior preserved hearts suggests post-ischemic myocardial stunning within the first 5 postoperative days. The positive correlation between impaired endothelial function and total ischemic time in the Celsior group requires longitudinal investigation in particular with regard to the development of allograft vasculopathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050326
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  • 2
    Electronic Resource
    Electronic Resource
    Endothelium-dependent microvascular vasomotion and its correlation with vasoactive mediators early after cardiac transplantation in humans (1998)
    Springer
    Transplant international 11 (1998), S. S519 
    Details
    ISSN: 1432-2277
    Keywords: Key words Nitric oxide ; Endothelin ; Humans ; Heart transplantation ; Endothelial function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endothelial dysfunction precedes and predicts transplant vasculopathy. We investigated the relationship between endothelial dysfunction and the vasoactive mediators nitric oxide and endothelin, 33.7 ± 2.0 days after heart transplantation. Coronary flow was measured in 18 patients to determine the endothelial microvascular vasomotor response to acetylcholine. Endomyocardial biopsies were taken to determine the levels of gene expression of isozymes of endothelin and nitric oxide synthases (NOS). Blood samples from the coronary sinus and aorta were withdrawn for measurement of endothelin, nitrite and cytokines. Five patients (30 %) showed an impaired coronary flow reserve response to acetylcholine, significantly higher inducible NOS gene expression and significant transcardiac nitrite production. Plasma nitrite correlated with tumour necrosis factor-alpha levels in coronary sinus and a transcardiac net extraction of endothelin was noted in all patients. In conclusion, 30 % of patients develop endothelial dysfunction early after heart transplantation; this correlates with the expression and activation of vasoactive and immunomodulatory mediators, which may predict the development of transplant vasculopathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050532
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    122. Verbesserung der regionalen Myokardfunktion durch die aortocoronare Bypass-Operation — Nichtinvasive Untersuchungen mit der First-Pass-Technik (1986)
    Springer
    Langenbeck's archives of surgery 369 (1986), S. 583-587 
    Details
    ISSN: 1435-2451
    Keywords: Coronary artery bypass grafting ; Regional ejection fraction ; First pass radionuclide angiography ; Aortocoronare Bypass-Operation ; Regionale Myokardfunktion ; First-Pass-Radionuklidangiographie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 50 operierte und 50 durch Matching zugeordnete nichtoperierte Patienten mit einer coronaren MehrgefäBerkrankung wurden nach einem Beobachtungszeitraum von vier Jahren mit der First Pass-Radionuklidangiographie nachuntersucht. Nach Revascularisation fanden sich signifikant höhere Werte für die regionale Ejektionsfraktion unter Belastung und in stenosierten Territorien mit bereits abgelaufenem Infarkt. Die Ergebnisse unterstreichen die hämodynamischen Verbesserungen durch die aortocoronare Bypass-Operation, wobei Regionen mit schlechter Ruhefunktion besonders von der Revascularisation profitierten.
    Notes: Summary 50 patients after coronary artery bypass grafting were matched with 50 not-operated patients. After a follow-up period of four years they were investigated by first pass radionuclide angiography. Revascularized myocardial areas showed significantly higher regional ejection fraction during exercise and in territories with prior myocardial infarction. The results proved the hemodynamic benefits of coronary artery bypass grafting even in territories with poor myocardial function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01274440
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    Paper (German National Licenses)
    Fulltext
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