Myocardial ischemia is more important than the effects of cardiopulmonary bypass on myocardial water handling and postoperative dysfunction: A pediatric animal model

Egan, Jonathan R.; Butler, Tanya L.; Cole, Alexander J.; Aharonyan, Avetis; Baines, David; Street, Neil; Navaratnam, Manchula; Biecker, Oliver; Zazulak, Carla; Au, Carol G.; Tan, Yee Mun; North, Klaus; Winlaw, David S.

doi:10.1016/j.jtcvs.2008.04.002

Cited by 25 publications

(18 citation statements)

References 30 publications

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“…Researchers have found that the AQP1 gene is intimately associated with the extent of cardiac necrosis in cardiopulmonary bypass and infarction models, which suggests a potential relationship between the myocardial ischemia and the maintenance of myocardial edema [35]. …”

Section: Pathways and Regulatory Mechanisms Of Vascular Leakagementioning

confidence: 99%

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Duan

Zhang

et al. 2017

Military Med Res

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Vascular leakage, or increased vascular permeability, is a common but important pathological process for various critical diseases, including severe trauma, shock, sepsis, and multiple organ dysfunction syndrome (MODS), and has become one of the most important causes of death for intensive care units (ICU) patients. Currently, although there has been some progress in knowledge of the pathogenesis of these vascular disorders, the detailed mechanisms remain unclear, and effective prophylaxis and treatment are still lacking. In this study, we aimed to provide a review of the literature regarding the regulatory mechanisms and prophylaxis as well as the treatment of vascular leakage in critical diseases such as severe trauma and shock, which could be beneficial for the overall clinical treatment of vascular leakage disorders.

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Section: Pathways and Regulatory Mechanisms Of Vascular Leakagementioning

confidence: 99%

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Duan

Zhang

et al. 2017

Military Med Res

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“…Water accumulation in the myocardium occurs as a result of ischemia [2,12], when ischemic tissue becomes hyperosmolar and attracts water from the capillary lumen. This water is transported through inter-endothelial clefts, as well as across the endothelial cells, potentially facilitated by AQP1 [3,12,34] and shedding of endothelial glycocalyx [4,8].…”

Section: Role Of Aqp4 In Ischemiamentioning

confidence: 99%

“…This water is transported through inter-endothelial clefts, as well as across the endothelial cells, potentially facilitated by AQP1 [3,12,34] and shedding of endothelial glycocalyx [4,8]. Then, it is transported into the myocardial cells, most importantly, cardiomyocytes.…”

Section: Role Of Aqp4 In Ischemiamentioning

confidence: 99%

Aquaporin-4 in the heart: expression, regulation and functional role in ischemia

et al. 2012

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Aquaporins (AQPs) are channel-forming membrane proteins highly permeable to water. AQP4 is found in mammalian hearts; however, its expression sites, regulation and function are largely unknown. The aim was to investigate cardiac AQP4 expression in humans and mice, its regulation by ischemia and hypoxia, and in particular its role in cardiac ischemic injury using AQP4 knockout (KO) mice. Comparable levels of AQP4 were detected by Western blot and qPCR in biopsies from human donor hearts and wild type C57Bl6 mouse hearts. In mice, AQP4 was expressed on cardiomyocyte plasmalemma (qPCR, Western blot, immunogold), and its mRNA decreased following ischemia/reperfusion (isolated hearts, p = 0.02) and after normobaric hypoxia in vivo (oxygen fraction 10 % for 1 week, p < 0.001). Isolated hearts from AQP4 KO mice undergoing global ischemia and reperfusion had reduced infarct size (p = 0.05) and attenuated left ventricular end-diastolic pressure during reperfusion (p = 0.04). Infarct size was also reduced in AQP4 KO mice 24 h after left coronary artery ligation in vivo (p = 0.036). AQP4 KO hearts had no compensatory change in AQP1 protein expression. AQP4 KO cardiomyocytes were partially resisted to hypoosmotic stress in the presence of hypercontracture. AQP4 is expressed in human and mouse hearts, in the latter confined to the cardiomyocyte plasmalemma. AQP4 mRNA expression is downregulated by hypoxia and ischemia. Deletion of AQP4 is protective in acute myocardial ischemia-reperfusion, and this molecule might be a future target in the treatment of acute myocardial infarction.

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“…Cardioplegic arrest may cause myocardial ischemia-reperfusion injury, which has been associated with systolic and diastolic dysfunction (50)(51)(52). Myocardial edema manifests as decreased contractility and stroke volume with elevated filling pressures.…”

Section: Cardiopulmonary Manifestationsmentioning

confidence: 99%

Pediatric Cardiac Intensive Care Society 2014 Consensus Statement

McCammond

Axelrod

Bailly

et al. 2016

Pediatric Critical Care Medicine

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Fluid management is challenging in critically ill pediatric cardiac patients. A myriad of causes may be contributory, including intrinsic myocardial dysfunction with its associated neuroendocrine response, renal dysfunction with oliguria, and systemic inflammation with resulting endothelial dysfunction. The development of fluid overload has been associated with adverse outcomes, including acute kidney injury, prolonged mechanical ventilation, increased vasoactive support, prolonged hospital length of stay, and mortality. An in-depth understanding of the many factors that influence volume status is necessary to guide optimal management.

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Myocardial ischemia is more important than the effects of cardiopulmonary bypass on myocardial water handling and postoperative dysfunction: A pediatric animal model

Cited by 25 publications

References 30 publications

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Aquaporin-4 in the heart: expression, regulation and functional role in ischemia

Pediatric Cardiac Intensive Care Society 2014 Consensus Statement

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