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Acute Regional Myocardial Ischemia and Recovery After Cardiopulmonary Bypass: Effects of Intensity of Antecedent Ischemia
Author(s) -
Leone Bruce J.,
Huggins Clarence P.,
Johns Jeffrey,
McRae R.L.,
Smith Betty,
White William
Publication year - 1995
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1995.tb00668.x
Subject(s) - medicine , cardiopulmonary bypass , ischemia , antecedent (behavioral psychology) , cardiology , myocardial ischemia , anesthesia , psychology , developmental psychology
A bstract Aortic cross‐clamping with inadequate myocardial preservation has been shown to cause postoperative decreases in myocardial performance following coronary artery bypass graft surgery. We have demonstrated a mild decrement in myocardial beta‐receptor function associated with cold cardioplegia in a normal animal model; in normal human hearts, however, response to beta‐adrenergic inotropic stimulation was diminished significantly. Beta‐receptor dysfunction also is associated with chronic myocardial ischemia that is associated with severe ischemic heart disease. Although the change in beta‐receptor function with acute regional myocardial ischemia associated with severe ischemic heart disease is not understood fully, we found that the intensity of regional ischemia significantly affects functional recovery after Cardiopulmonary bypass (CPB). Myocardial stunning does not appear to be significant in this dysfunction; however, alterations in beta‐receptor density and function may play a critical role in post‐CPB ventricular function.