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  • Endothelial function  (2)
  • Endothelin  (2)
  • Aortocoronare Bypass-Operation  (1)
  • Aortocoronarer Bypass  (1)
  • 1
    Electronic Resource
    Electronic Resource
    An association between microvascular endothelial dysfunction, transcardiac nitric oxide production and pro-inflammatory cytokines after heart transplantation in humans (2000)
    Springer
    Transplant international 13 (2000), S. S228 
    Details
    ISSN: 1432-2277
    Keywords: Key words Transplantation ; Nitric oxide ; Endothelial function ; Gene expression ; Cytokines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endothelial dysfunction anticipates the development of transplant coronary artery disease (TxCAD) observed more than 1 year after transplantation (HTx). We investigated whether in patients early after HTx myocardial inducible and constitutive nitric oxide synthases (iNOS; cNOS) are expressed and cardiac nitric oxide production occurs. Moreover, a possible relationship to alterations in endothelium dependent and independent vasomotor function was assessed. Forty-two transplant recipients were studied 37 ± 5 days after HTx. Microvascular coronary flow velocity reserve (CFVR) was tested endothelium dependent (acetylcholine; 30 μg/min × 5 min/i.c.) and independent (adenosine; 160 μg/min × 5 min/i.c.) by Doppler flow wire. Flow velocity increase by a factor greater than 2 was considered normal. Quantitative coronary angiography was used to assess epicardial vasomotor function in response to the same stimuli. Myocardial iNOS and cNOS gene expression were detected by semiquantitative reversed transcriptase polymerase chain reaction. Plasma nitrite levels (μM) were measured by spectrophotometry. Cytokines (TNF-a, IL-6; pg/ml) were measured by enzyme linked immunosorbent assay. In 26.1 % of patients (n = 11; group A) an impaired endothelium dependent CFVR (1.65 ± 0.23 increase) was observed; in 73.9 % (n = 31, group B) a normal endothelium dependent CFVR (3.0 ± 0.7 increase; P = 0.003) was observed. Myocardial iNOS and cNOS gene expression did not differ between the two groups. Transcardiac cytokine production was noted in 58.8 % of patients for IL-6 and in 53.3 % for TNF-α. Coronary sinus (CS) levels of TNF-α, IL-6 and nitrite were higher in group A. A significant increase in nitrite production was found only in patients with impaired endothelium dependent CFVR (aorta: 43.9 ± 3.7 vs CS: 52.8 ± 5.6, P = 0.05), suggesting transcardiac nitric oxide production. In addition, CS nitrite levels correlated with CS TNF-a levels in patients with impaired CFVR (r = 0.44, P = 0.003). Microvascular endothelium dependent CFVR is impaired in 26 % of patients early after HTx. Activation of cytokines and the NO pathway seem to be involved in this vasomotor dysfunction The association between cardiac nitric oxide production and TNF-a in this group indicates a chronic high immunologic process, which may represent an early and important target for therapy and prevention of TxCAD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050330
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    Paper (German National Licenses)
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  • 2
    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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    Paper (German National Licenses)
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  • 3
    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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  • 4
    Electronic Resource
    Electronic Resource
    131. Chirurgische Möglichkeiten bei schlechter Ventrikelfunktion bzw. bei diffuser Coronarsklerose (1984)
    Springer
    Langenbeck's archives of surgery 364 (1984), S. 471-472 
    Details
    ISSN: 1435-2451
    Keywords: Aortocoronary bypass ; Impaired left ventricular function ; Diffuse vessel disease ; Aortocoronarer Bypass ; Schlechte Ventrikelfunktion ; Diffuse Coronarsklerose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Patienten mit einer prdoperativen Ejektionsfraktion (EF) unter 40% weisen eine erhöhte Frühletalität auf (7,3% gegenüber 1,7%); die 5-Jahres-überlebenschance (Actuarial-Methode) bei präop. EF unter 30% betrugt 55% - bei präop. EF zwischen 31 % und 40% betragt sie 85%. Die komplette Revascularisation ist bei Patienten mit diffuser Coronarsklerose am wichtigsten. Unsere 19 mit der Herzbinnenraumszintigraphie nachuntersuchten Patienten erhielten im Schnitt 5,3 Anastomosen, wichtigstes Revascularisationsgebiet ist die RIVA-Region.
    Notes: Summary Patients with preoperative ejection fractions (EF) below 40% show increased early mortality (7.3% versus 1.7%). Whenever the preoperative EF was below 30%, the 5-year survival rate (actuarial method) measured 55%; in patients with a preoperative EF between 31% and 40%, the survival rate was 85%. For patients with diffuse coronary artery disease complete revascularization is most important. Of the 19 patients we reexamined, using a radionuclide technique, there was a mean 5.3 anastomosis; complete revascularization of the LAD region is the most important.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01823304
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    Paper (German National Licenses)
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  • 5
    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)
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