Effects of epinephrine on the myocardial performance and haemodynamics of the isolated rat heart during moderate hypothermia — importance of calcium homeostasis

Schiffmann, Holger; Gleiss, J; Hirscheydt, Axel von; Schröder, T.; Kahles, H.; Hellige, G.

doi:10.1016/s0300-9572(01)00357-4

Cited by 19 publications

(27 citation statements)

References 26 publications

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“…dP/dt min becomes less negative with cooling not only under decreasing HR (Schiffmann et al 2001;Tveita et al 1994Tveita et al , 1998 but also under constant HR (Mattheussen et al 1996). In our present study, dP/dt min also became less negative with decreasing temperature and more negative with increasing temperature in the paced heart (Table 1).…”

Section: Diastolic Function and Temperaturesupporting

confidence: 64%

Half-logistic time constant: a more reliable lusitropic index than monoexponential time constant regardless of temperature in canine left ventricle

Mizuno

Matsubara

Mohri

et al. 2008

Can. J. Physiol. Pharmacol.

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Temperature changes influence cardiac diastolic function. The monoexponential time constant (tauE), which is a conventional lusitropic index of the rate of left ventricular (LV) pressure fall, increases with cooling and decreases with warming. We have proposed that a half-logistic time constant (tauL) is a better lusitropic index than tauE at normothermia. In the present study, we investigated whether tauL can remain a superior measure as temperature varies. The isovolumic relaxation LV pressure curves from the minimum of the first time derivative of LV pressure (dP/dtmin) to the LV end-diastolic pressure were analyzed at 30, 33, 36, 38, and 40 degrees C in excised, cross-circulated canine hearts. tauL and tauE were evaluated by curve-fitting using the least squares method and applying the half-logistic equation, P(t) = PA/[1 + exp(t/tauL)] + PB, and the monoexponential equation, P(t) = P0exp(-t/tauE) + Pinfinity. Both tauL and tauE increased significantly with decreasing temperature and decreased with increasing temperature. The half-logistic correlation coefficient (r) values were significantly higher than the monoexponential r values at the 5 above-mentioned temperatures. This implies that the superiority of the goodness of the half-logistic fit is not temperature dependent. The half-logistic model characterizes the amplitude and time course of LV pressure fall more reliably than the monoexponential model. Hence, we concluded that tauL is a more useful lusitropic index regardless of temperature.

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Section: Diastolic Function and Temperaturesupporting

confidence: 64%

Half-logistic time constant: a more reliable lusitropic index than monoexponential time constant regardless of temperature in canine left ventricle

Mizuno

Matsubara

Mohri

et al. 2008

Can. J. Physiol. Pharmacol.

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“…The effects of hypothermia on calcium homeostasis have been widely studied in animal models both in vitro and in vivo [13][14][15][16][17][18][19]. The investigation of calcium levels in animal cardiac and hepatic cells under cold conditions revealed significant increase in baseline calcium that was gradual and sustained during the whole process of acute hypothermia [13,14].…”

Section: Discussionmentioning

confidence: 99%

Post-mortem investigation of calcium content in liver, heart, and skeletal muscle in accidental hypothermia cases

Jakubeniene

Irnius

Chaker

et al. 2009

Forensic Science International

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“…Depressed CO (high dose) [21, 27, 34, 35, 37]. Negative inotropic effects (in vitro) [41, 42]. Increased contractile force [26, 45].…”

Section: Methodsmentioning

confidence: 99%

“…This assumptions gain support by data from in vitro experiments. In isolated rat hearts, both SV and CO were depressed by adrenaline at 28 °C [41], while at 12 °C positive inotropic effects were absent [42]. Interestingly, Schiffmann et al demonstrated that in normothermic rat hearts, the presence of additionally added calcium would potentiate the inotropic effects of adrenaline.…”

Section: Methodsmentioning

confidence: 99%

“…Interestingly, Schiffmann et al demonstrated that in normothermic rat hearts, the presence of additionally added calcium would potentiate the inotropic effects of adrenaline. In the hypothermic heart however, increased calcium concentrations [41] mediated a depressive effect of adrenaline on SV and CO. Thus, the negative effects of adrenaline at low temperatures could be a consequence of hypothermia-induced calcium overload, reported in vitro [43], as well as in vivo [29, 30].…”

Section: Methodsmentioning

confidence: 99%

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Altered pharmacological effects of adrenergic agonists during hypothermia

Dietrichs

Sager

Tveita

2016

Scand J Trauma Resusc Emerg Med

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Rewarming from accidental hypothermia is often complicated by hypothermia-induced cardiac dysfunction, calling for immediate pharmacologic intervention. Studies show that although cardiac pharmacologic support is applied when rewarming these patients, a lack of updated treatment recommendations exist. Mainly due to lack of clinical and experimental data, neither of the international guidelines includes information about pharmacologic cardiac support at temperatures below 30 °C. However, core temperature of accidental hypothermia patients is often reduced below 30 °C. Few human studies exploring effects of adrenergic drugs during hypothermia have been published, and therefore prevailing information is collected from pre-clinical studies. The most prominent finding in these studies is an apparent depressive effect of adrenaline on cardiac function when used in doses which elevate cardiac output during normothermia. Also noradrenaline and isoprenaline largely lacked positive cardiac effects during hypothermia, while dopamine is a more promising drug for supporting cardiac function during rewarming. Data and information from these studies are in support of the prevailing notion; not to use adrenergic drugs at core temperatures below 30 °C.

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Effects of epinephrine on the myocardial performance and haemodynamics of the isolated rat heart during moderate hypothermia — importance of calcium homeostasis

Cited by 19 publications

References 26 publications

Half-logistic time constant: a more reliable lusitropic index than monoexponential time constant regardless of temperature in canine left ventricle

Half-logistic time constant: a more reliable lusitropic index than monoexponential time constant regardless of temperature in canine left ventricle

Post-mortem investigation of calcium content in liver, heart, and skeletal muscle in accidental hypothermia cases

Altered pharmacological effects of adrenergic agonists during hypothermia

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