Intravenous phenylephrine preconditioning of cardiac grafts from non- heart-beating donors

Jeffrey T. Cope, Michael C. Mauney, David Banks, Oliver A.R. Binns, Christopher L. Moore, Jeffrey J. Rentz, Kimberly S. Shockey, R. Christoper King, Irving L. Kron, Curtis G. Tribble

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background. Hypoxia and warm ischemia produce severe injury to cardiac grafts harvested from non-heartbeating donors. To potentially improve recovery of such grafts, we studied the effects of intravenous phenylephrine preconditioning. Methods. Thirty-seven blood-perfused rabbit hearts were studied. Three groups of non-heart-beating donors underwent intravenous treatment with phenylephrine at 12.5 (n = 8), 25 (n = 7), or 50 μg/kg (n = 7) before initiation of apnea. Non-heart-beating controls (n = 8) received saline vehicle. Hypoxic cardiac arrest occurred after 6 to 12 minutes of apnea, followed by 20 minutes of warm in vivo ischemia. A 45-minute period of ex vivo reperfusion ensued. Nonischemic controls (n = 7) were perfused without antecedent hypoxia or ischemia. Results. Phenylephrine 25 μg/kg significantly delayed the onset of hypoxic cardiac arrest compared with saline controls (9.6 ± 0.5 versus 7.7 ± 0.4 minutes; p = 0.00001) yet improved recovery of left ventricular developed pressure compared with saline controls (57.1 ± 5.3 versus 41.0 ± 3.4 mm Hg; p = 0.04). Phenylephrine 25 μg/kg also yielded a trend toward less myocardial edema than saline vehicle (p = 0.09). Conclusions. Functional recovery of nonbeating cardiac grafts is improved by preconditioning. We provide evidence that the myocardium can be preconditioned with phenylephrine against hypoxic cardiac arrest.

Original languageEnglish (US)
Pages (from-to)1664-1668
Number of pages5
JournalAnnals of Thoracic Surgery
Volume63
Issue number6
DOIs
StatePublished - Jun 1 1997
Externally publishedYes

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Phenylephrine
Transplants
Heart Arrest
Apnea
Ischemia
Warm Ischemia
Ventricular Pressure
Reperfusion
Edema
Myocardium
Rabbits
Wounds and Injuries
Hypoxia

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Cope, J. T., Mauney, M. C., Banks, D., Binns, O. A. R., Moore, C. L., Rentz, J. J., ... Tribble, C. G. (1997). Intravenous phenylephrine preconditioning of cardiac grafts from non- heart-beating donors. Annals of Thoracic Surgery, 63(6), 1664-1668. https://doi.org/10.1016/S0003-4975(97)00092-1

Intravenous phenylephrine preconditioning of cardiac grafts from non- heart-beating donors. / Cope, Jeffrey T.; Mauney, Michael C.; Banks, David; Binns, Oliver A.R.; Moore, Christopher L.; Rentz, Jeffrey J.; Shockey, Kimberly S.; King, R. Christoper; Kron, Irving L.; Tribble, Curtis G.

In: Annals of Thoracic Surgery, Vol. 63, No. 6, 01.06.1997, p. 1664-1668.

Research output: Contribution to journalArticle

Cope, JT, Mauney, MC, Banks, D, Binns, OAR, Moore, CL, Rentz, JJ, Shockey, KS, King, RC, Kron, IL & Tribble, CG 1997, 'Intravenous phenylephrine preconditioning of cardiac grafts from non- heart-beating donors', Annals of Thoracic Surgery, vol. 63, no. 6, pp. 1664-1668. https://doi.org/10.1016/S0003-4975(97)00092-1
Cope, Jeffrey T. ; Mauney, Michael C. ; Banks, David ; Binns, Oliver A.R. ; Moore, Christopher L. ; Rentz, Jeffrey J. ; Shockey, Kimberly S. ; King, R. Christoper ; Kron, Irving L. ; Tribble, Curtis G. / Intravenous phenylephrine preconditioning of cardiac grafts from non- heart-beating donors. In: Annals of Thoracic Surgery. 1997 ; Vol. 63, No. 6. pp. 1664-1668.
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abstract = "Background. Hypoxia and warm ischemia produce severe injury to cardiac grafts harvested from non-heartbeating donors. To potentially improve recovery of such grafts, we studied the effects of intravenous phenylephrine preconditioning. Methods. Thirty-seven blood-perfused rabbit hearts were studied. Three groups of non-heart-beating donors underwent intravenous treatment with phenylephrine at 12.5 (n = 8), 25 (n = 7), or 50 μg/kg (n = 7) before initiation of apnea. Non-heart-beating controls (n = 8) received saline vehicle. Hypoxic cardiac arrest occurred after 6 to 12 minutes of apnea, followed by 20 minutes of warm in vivo ischemia. A 45-minute period of ex vivo reperfusion ensued. Nonischemic controls (n = 7) were perfused without antecedent hypoxia or ischemia. Results. Phenylephrine 25 μg/kg significantly delayed the onset of hypoxic cardiac arrest compared with saline controls (9.6 ± 0.5 versus 7.7 ± 0.4 minutes; p = 0.00001) yet improved recovery of left ventricular developed pressure compared with saline controls (57.1 ± 5.3 versus 41.0 ± 3.4 mm Hg; p = 0.04). Phenylephrine 25 μg/kg also yielded a trend toward less myocardial edema than saline vehicle (p = 0.09). Conclusions. Functional recovery of nonbeating cardiac grafts is improved by preconditioning. We provide evidence that the myocardium can be preconditioned with phenylephrine against hypoxic cardiac arrest.",
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AU - Banks, David

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AU - Moore, Christopher L.

AU - Rentz, Jeffrey J.

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AU - Kron, Irving L.

AU - Tribble, Curtis G.

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N2 - Background. Hypoxia and warm ischemia produce severe injury to cardiac grafts harvested from non-heartbeating donors. To potentially improve recovery of such grafts, we studied the effects of intravenous phenylephrine preconditioning. Methods. Thirty-seven blood-perfused rabbit hearts were studied. Three groups of non-heart-beating donors underwent intravenous treatment with phenylephrine at 12.5 (n = 8), 25 (n = 7), or 50 μg/kg (n = 7) before initiation of apnea. Non-heart-beating controls (n = 8) received saline vehicle. Hypoxic cardiac arrest occurred after 6 to 12 minutes of apnea, followed by 20 minutes of warm in vivo ischemia. A 45-minute period of ex vivo reperfusion ensued. Nonischemic controls (n = 7) were perfused without antecedent hypoxia or ischemia. Results. Phenylephrine 25 μg/kg significantly delayed the onset of hypoxic cardiac arrest compared with saline controls (9.6 ± 0.5 versus 7.7 ± 0.4 minutes; p = 0.00001) yet improved recovery of left ventricular developed pressure compared with saline controls (57.1 ± 5.3 versus 41.0 ± 3.4 mm Hg; p = 0.04). Phenylephrine 25 μg/kg also yielded a trend toward less myocardial edema than saline vehicle (p = 0.09). Conclusions. Functional recovery of nonbeating cardiac grafts is improved by preconditioning. We provide evidence that the myocardium can be preconditioned with phenylephrine against hypoxic cardiac arrest.

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