Effect of Ischemia and Antianginal Drugs on the Distribution of Radioactive Microspheres in the Canine Left Ventricle

Becker, Lewis C.; Fortuin, Nicholas J.; Pitt, Bertram

doi:10.1161/01.res.28.2.263

Cited by 366 publications

(93 citation statements)

References 36 publications

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“…Since occlusion of a coronary artery results in a heterogeneous pattern of blood flow in and around the area of tissue supplied by the occluded artery (8), it was of interest to study the rates of energy metabolism that might be expected in the peripheral central areas of the ischemic tissue. One would expect the rate of oxygen consumption and ATP production from oxidative metabolism to be proportional to coronary blood flow and to also occur in a heterogeneous pattern.…”

Section: Discussionmentioning

confidence: 99%

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Effect of coronary blood flow on glycolytic flux and intracellular pH in isolated rat hearts.

Neely¹,

Whitmer²,

Rovetto³

1975

Circulation Research

197

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The rate of coronary blood flow was varied in isolated working rat heart preparations to determine its influence on the rate of glucose utilization, tissue high-energy phosphates, and intracellular pH. A 60% reduction in coronary blood flow resulted in a 30% reduction in oxygen consumption, an accelerated rate of glucose utilization, lower tissue levels of high-energy phosphates, and higher tissue levels of lactate and H + . Ventricular performance deteriorated as reflected by a decrease in heart rate and peak systolic pressure. Further reductions in coronary blood flow resulted in inhibition of glycolysis, a greater decrease in tissue levels of high-energy phosphates, and higher tissue levels of both lactate and H + . These changes in glycolytic flux, tissue metabolites, and ventricular performance were proportional to the degree of restriction in coronary blood flow. The importance of coronary blood flow and washout of the interstitial space in the maintenance of accelerated glycolytic flux in oxygen-deficient hearts is emphasized. It is concluded that acceleration of ATP production from glycolysis can occur only in the marginally ischemic tissue in the peripheral area of tissue supplied by an occluded artery. The central area of tissue which receives a low rate of coronary blood flow will have a reduced rate of ATP production due to both a lack of oxygen and an inhibition of glycolysis.

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Section: Discussionmentioning

confidence: 99%

“…The time of onset of cell death may be directly proportional to the restriction in coronary blood flow. Several studies (7)(8)(9)(10)(11)(12)(13)(14) have emphasized the heterogeneity of blood flow in and around an infarcting region. Flow ranges from near zero in the center of the infarcting zone to normal or above normal in the surrounding, tissue.…”

mentioning

confidence: 99%

Effect of coronary blood flow on glycolytic flux and intracellular pH in isolated rat hearts.

Neely¹,

Whitmer²,

Rovetto³

1975

Circulation Research

197

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“…Studies on seven normal subjects (mean age 34 years, range [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] were carried out to define the dose (concentration) response relationship during increasing propranolol administration. This relationship was defined in normal subjects because it was not possible to exercise the patients with angina to the level at which adrenergic stimuli were the dominant factor in heart rate control.…”

mentioning

confidence: 99%

Correlation of plasma propranolol concentration with therapeutic response in patients with angina pectoris.

Pine¹,

Favrot²,

Smith³

et al. 1975

Circulation

106

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SUMMARYThe therapeutic response to propranolol was evaluated in patients with documented coronary artery disease at doses varying from 40 to 320 mg/day. Therapeutic response was quantified by evaluating exercise performance on a treadmill and then related to plasma propranolol concentration. Plasma propranolol was defined in terms of beta-adrenergic blockade by comparison with dose (concentration) response curves in normal subjects. Individual therapeutic benefit occurred at doses which averaged 144 ± 21 mg/day and at concentrations which averaged 30 ± 7 ng/ml. There was a wide variation between both dose and concentration among the patients at maximum therapeutic response, but when the plasma propranolol was related to pharmacologic activity, the maximum therapeutic response was observed between 64 to 98% of total blockade. Despite the increased exercise performance in these patients, the double product of heart rate and systolic blood pressure was always less, suggesting either an alteration of the relation between myocardial oxygen consumption and the double product during propranolol or a reduction on oxygen delivery to the myocardium as the result of beta-adrenergic blockade of the coronary vasculature. Received April 16, 1975; revision accepted for publication June 20, 1975. 886 utilize plasma propranolol levels have also been con-The present study was designed to re-examine this problem comparing improvement in exercise tolerance with the oral dose of propranolol and its plasma level. We have used a more sensitive and specific method for the measurement of propranolol,10 which appears to be necessary to make meaningful measurement of plasma levels at lower doses of the drug in patients with angina.9 The plasma propranolol concentrations then were interpreted in terms of betaadrenergic receptor blockade by relating them to a dose (concentration) response curve defined in normal subjects. Thus, the plasma levels could be used to assess the extent of beta blockade in the patients' studies. Finally, the hemodynamic responses to increasing propranolol were examined in relation to the therapeutic activity of the drug. MethodsStudies on seven normal subjects (mean age 34 years, range 28-44) were carried out to define the dose (concentration) response relationship during increasing propranolol administration. This relationship was defined in normal subjects because it was not possible to exercise the patients with angina to the level at which adrenergic stimuli were the dominant factor in heart rate control."1 Furthermore, in these patients, propranolol could not be administered to high enough doses to establish a maximum pharmacologic effect, i.e., plateau of heart rate suppression with increased propranolol concentrations. Observations during exercise were made only after initial conditioning using three practice exercise runs. Subjects were studied during a control

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“…Intravenous nitroglycerin or sodium nitroprusside can be used but nitroglycerin is less potent as an arterial vasodilator 28 .It may also have the advantage of not producing coronary "steal" (preferential coronary blood flow to non-ischaemic vascular beds) 29 . Vasodilatorsare particularly important when mitral regurgitation is a major part of the pathophysiologic process.…”

Section: Treatment General Supportive Measuresmentioning

confidence: 99%

Pulmonary Hypertension in A Patient with Systemic Sclerosis

S.T¹,

Ezennaka²

2017

IOSR JDMS

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INTRODUCTION:Cardiogenic shock (CS) is defined as a state of critical end organ hypoperfusion due to reduced cardiac output.The most frequent cause is acute myocardial infarction (AMI) with subsequent ventricular dysfunction in about 80% of cases. In spite of the advances made in the treatment of AMI, cardiogenic shock remains a leading cause of death with mortality rates approaching 40-50%. AIM: The purpose of this review is to highlight the current concepts in the management of cardiogenic shock. MATERIALS AND METHODS: A systematic review of published literature using PubMed and Med Line was done using search items like "cardiogenic and shock". Secondary references obtained from this publication were identified by manual search and reviewed as relevant. RESULTS: Cardiogenic shock is characterized by inadequate tissue perfusion in the setting of adequate intravascular volume. The treatment involves general supportive measures which include; adequate oxygenation and ventilation, correction of electrolytes and acid-base abnormalities, pain reliefand restoration of sinus rhythm. Revascularizationand mechanical supports are also necessary. CONCLUSION:The diagnosis and management of cardiogenic shock are difficult and require extensive knowledge and clinical experience. In spite of the significant advances made, the management still remains a challenge.

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Effect of Ischemia and Antianginal Drugs on the Distribution of Radioactive Microspheres in the Canine Left Ventricle

Cited by 366 publications

References 36 publications

Effect of coronary blood flow on glycolytic flux and intracellular pH in isolated rat hearts.

Effect of coronary blood flow on glycolytic flux and intracellular pH in isolated rat hearts.

Correlation of plasma propranolol concentration with therapeutic response in patients with angina pectoris.

Pulmonary Hypertension in A Patient with Systemic Sclerosis

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