• Title/Summary/Keyword: Inotropic

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The Value of Mixed Venous Oxygen Saturation during and after Cardiopulmonary Bypass (체외순환중의 중심 정맥 산소포화도의 의의)

  • 이재원
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.7-10
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    • 1995
  • Mixed Venous oxygenation saturation[SvO2 is a variable determined in part by the externally controlled factors and in part by the patient during CPB. I monitored the SvO2 and tested it as a parameter for the regulation of pump output and as a criteria for the need of inotropics after CPB. With the help of SvO2, I increased the pump flow especially during rewarming for more optimal oxygenation of cells. After CPB, the calculated cardiac index was used as an indicator for the need of inotropic support with greater accuracy and without any clinical problems. I conclude that the SvO2 is an easily checkable variable and a good indicator for optimal oxygenation at cell level, and can be used as an objective criteria for the need of postoperative inotropic support.

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Effects of Aconiti tuber butanol fraction and several cardiotonics on the mechanical properties of cat papillary muscle preparation (수종강심약물(數種强心藥物)과 부자(附子)"부타놀" 분획(分劃)이 심장근(心臟筋)의 기계적(機械的) 성질(性質)에 미치는 영향(影響))

  • Yoon, Choong
    • The Korean Journal of Pharmacology
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    • v.12 no.1
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    • pp.45-55
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    • 1976
  • The effect of positive inotropic agents on the contractile properties of myocardial muscle were studied in the cat papillary muscle preparation. For the purpose, the effects of ouabain $(1{\times}10^{-6}g/ml)$, norepinephrine (0.05r/m1) and Aconiti tuber butanol fraction (AF(5), $1{\times}10^{-4}$, $5{\times}10^{-4}$, $1{\times}10^{-3}$, $2{\times}10^{-3}g/ml$) on the contractile dynamics of the papillary muscle preparation isolated from right ventricle of cat were observed in terms of the characteristics of isometric twitch and the lengh-tension relation, the force-velocity relation and the load-extension relation of the series elastic component of contractile model of A.V. Hill. All the studied inotropic drugs similary increased the rate and the intensity of the developed isometric tension, while shortened the time from onset of contraction to peak tension and the total duration of contraction. In the afterloaded simultaneous isotonic and isometric contraction, they also similary increased the maximal velocity of shortening accompanied with the increasing the maximum developed force. In the load-extension relation all the drugs, however, had no appreciable influence on the properties of the series elastic component. Increasing the concentration, Aconiti tuber butanol fraction produced more pronounced effect on all the studied parameters of isometric and isotonic contraction of cat papillary muscle preparation. From the aspect of contractile dynamics, it seemed that the positive inotropic effect of ouabain, norepinephrine and Aconiti tuber butanol fraction are similary achieved through an influence on the behavior of the contractile component only.

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Cardiovascular Effects of Novel Potassium Channel Opener SKP-450 and SKP-818 in Isolated Rat Heart and Aorta (신규 합성 $K_{ATP}$ 통로 개방제인 SKP-450과 대사체 SKP-818의 흰쥐 적출 심장 및 대동맥에 대한 작용)

  • Jung, Yi-Sook;Moon, Chang-Hyun;Yoo, Sung-Eun;Shin, Hwa-Sup
    • YAKHAK HOEJI
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    • v.41 no.2
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    • pp.241-246
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    • 1997
  • The effect of potassium channel openers, SKP-450, SKP-818 and lemakalim have been compared in rat heart and aorta. In rat isolated heart, SKP-450 had a greater negative inotrop ic effect than lemakalim and KR-30818 against left ventricular developed pressure (LVDP) and double product of heart rate and LVDP (DP). In addition, SKP-450 had a greater effect than lemakalim and KR-30818 in increasing coronary flow, indicating a more potent vasodilating effect in coronary artery. Negative inotropic effect and coronary vasodilating effect of SKP-450 and SEP-818 were significantly reduced by 10 min-perfusion with $10^{-6}M$ glyburide, a selective blocker of ATP-sensitive potassium channel. In rat aorta, SKP-30450 and SKP-30818 as well as lemakalim induced powerful concentration-dependent relaxations against norepinephrinc-induced tone ($EC_{50},\;{\mu}M$ : SKP-30450, $0.107{\pm}0.009$; SKP-30818, $0.476{\pm}0.022$ ; lemakalim, $0.565{\pm}0.039$ ). These relaxant effects were significantly reduced by pretreatment with glyburide. In sununary, SKP-30450 and SKP-30818 showed greater negative inotropic and vasorelaxant effect than lemakalim in rat aorta with order of potency of SKP-30450 > SKP-30818 > lemakalim. These actions are suggested to be mediated at least in part by a mechanism which involves the opening of ATP-sensitive potassium channel.

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Effects of Dopamine on the Contractility and Action Potential of the Rabbit Papillary Muscle (Dopamine이 토끼 유두근의 수축력과 활동전압에 미치는 영향)

  • Huh, In-Hoi;Park, Jong-Wan
    • YAKHAK HOEJI
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    • v.32 no.6
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    • pp.402-414
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    • 1988
  • In order to clarify the receptor types and mechanisms underlying the positive inotropic effect of dopamine on the mammalian ventricular myocardium, the action potential, its first derivatives and isometric contraction of the rabbit papillary muscle were recorded using a force transducer and glass capillary microelectrodes filled with 3M KCl. The results were as follows; (1) In normal Tyrode solution, the contractile force was increased and duration of action potential was shortened with increments of dopamine concentration ($10^{-6}-10^{-4}M$). (2) The dose-response curve was markedly shifted to the right by pretreatment with reserpine (5mg/kg i.p., 24hrs prior to the experiment). (3) In 19mM $K^+-Tyrode$ solution, the duration of action potential, maximum rate of rise (V_{max}) of action potential and overshoot were significantly increased with increments of dopamine concentration ($10^{-6}-10^{-4}M$). (4) The inotropic effect of dopamine on the rabbit papillary muscle pretreated with reserpine was antagonized by atenolol ($10^{-6}M$), but not by phentolamine ($3{\times}10^{-6}M$). (5) In rabbit papillary muscle partially depolarized by 19mM $K^+-Tyrode$ solution, slow electrical response (calcium mediated action potential) as well as contraction were restored by dopamine ($10^{-4}M$); this restoration was blocked by calcium antagonists ($3{\times}10^{-5}M$ $LaCl_3{\cdot}6H_2O$, $3{\times}10^{-6}M$ diltiazem) or ${\beta}-adrenoceptor$ antagonist ($3{\times}10^{-6}M$ atenolol), but not affected by ${\alpha}-adrenoceptor$ antagonist ($10^{-5}M$ phentolamine, $3{\times}10^{-6}M$ yohimbine) or vascular dopaminergic receptor antagonist ($10^{-5}M$ haloperidol). The above results may be interpreted as that the positive inotropic effect of dopamine through both direct and indirect action are caused by increase in slow inward current ($Ca^{2+}$ influx into themyocardial cell), and the direct action is mainly due to the stimulation of ${\beta}-adrenoceptors$ in the rabbit papillary muscle.

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Effects of Chrysosplenol C on Intracellular $Ca^{2+}$ Transient in Isolated Rat Ventricular Myocytes (Chrysosplenol C가 분리한 백서 심실 근세포 $Ca^{2+}$ Transient에 미치는 효과)

  • Jung, Suk-Han;Huong, Do Thi Thu;Sung, Tran Van;Cuong, Nguyen Manh;Kim, Young-Ho;Woo, Sun-Hee
    • YAKHAK HOEJI
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    • v.55 no.2
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    • pp.168-171
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    • 2011
  • Chrysosplenol C [5,6-dihydroxy-2-(4-hydroxy-3-methoxyphenyl)-3,7-dimethoxychromen-4-one] is a flavonoid found in Miliusa balansae and Pterocaulon sphacelatum. We have recently shown that chrysosplenol C has positive inotropic effect in isolated rat ventricular myocytes. In the present study, we explored a possible mechanism for the positive inotropic effect of chrysosplenol C by examining intracellular $Ca^{2+}$ transients during action potentials. The intracellular $Ca^{2+}$ transients were measured by confocal $Ca^{2+}$ imaging in field-stimulated single rat ventricular myocytes. Chrysosplenol C (50 ${\mu}M$) significantly increased the magnitudes (${\Delta}F/F_0$) of $Ca^{2+}$ transients (control, $1.08{\pm}0.05$; chrysosplenol C, $1.25{\pm}0.03$; n=8, P<0.01). Half decay time of the action potential-induced $Ca^{2+}$ transient was not altered by chrysosplenol C (50 ${\mu}M$) (control, $154{\pm}6$ ms; chrysosplenol C, $167{\pm}11$ ms; n=21). The $Ca^{2+}$ content in the sarcoplasmic reticulum (SR), measured as caffeine (10 mM)-induced $Ca^{2+}$ transient, was significantly decreased by chrysosplenol C (50 ${\mu}M$). These results indicate that chrysosplenol C increases $Ca^{2+}$ transients without altering $Ca^{2+}$ removal kinetics in ventricular myocytes, providing a possible mechanism for its positive inotropic effect.

Protective Effects of Ginkgolide B on Reperfusion of the Isolated Perfused Guinea Pig Heart (Ginkgolide B의 Guinea Pig 적출 심장에 대한 허혈 유발후 Reperfusion시의 보호 작용에 관한 연구)

  • Kwon, Kwang-il;Lee, Young-sin;Lee, Jae-heung
    • Korean Journal of Clinical Pharmacy
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    • v.3 no.2
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    • pp.147-155
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    • 1993
  • The cardiac effects of PAF antagonist Ginkgolide B(BN 52051) have been investigated on the isolated perfused guinea pig hearts maintained at the constant hydrostatic perfusion pressure of 80 cm water. PDE(Phosphodiesterase) inhibitor KR-30289 was used as a positive control to see the positive inotropic effects on the perfused hearts. In this expriments, Ginkgolide $B(10^{-5}-SM)$ showed negative inotropic effects by decreasing of LVP, LVDP, LV dp/dt, HR and RPP(Rate Pressure Product). Ginkgolide B also decreased the number of extrasystole by $51.9\%(from\;23.75\pm9.22/min\;to\;11.43\pm435/min)$ induced by global ischemia and reperfusion. The rate, [-dp/dt]/[+dp/dt] increased in preischemia but decreased in postischemia. 1n the separated study the injection of 1ml of Ginkgolide B$(10^{-4M})$ on the isolated heart, increased coronary flow(CF) by $11.8\%(from\;7.5\pm7.65ml/min\;to\;8.5\pm0.29ml/min)$ and decreased the number of extrasystole by $47.6\%(from\;21\pm5.92/min\;to\;11\pm5.27/min)$. In conclusion, Ginkgolide B showed antiarrhythmic and protective effects by decreasing the number of extrasystole and by increasing the coronary flow, respectively.

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Studies on the Efficacy of Combined Preparation of Crude Drugs(XXXII) -The Effect of Shihogesikungang-tang on the Central Nervous and Cardiovascular Systems- (생약(生藥) 복합제제(複合製劑)의 약효(藥效) 연구(硏究)(제32보)(第32報) -시호계지건강탕(柴胡桂枝乾薑湯)이 중추신경계(中樞神經系) 및 순환기계(循環器系)에 미치는 영향(影響)-)

  • Yoon, Myung-Sik;Kim, Nam-Jae;Lee, Kyung-Sup;Hong, Nam-Doo
    • Korean Journal of Pharmacognosy
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    • v.17 no.4
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    • pp.272-279
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    • 1986
  • This study was conducted about the effect of Shihogesikungang-tang on the central nervous system and cardiovascular system for the investigation of its clinical effect based on the Oriental medicinal references. The results of this study were summerized as follows; Analgesic activity as evaluated by the writhing syndrome in mice was significantly noted. A decrease effect of the spontaneous movement as estimated by wheel cage method, muscle relaxant effect as evaluated by the rotor rod method and the prolonged effect of sleeping time induced by thiopental-Na were significantly shown in mice. A antipyretic activity in febrile rats induced by the endotoxin was recognized. Anti-inflammatory effect in carrageen-induced paw edema in rats was significantly noted. Negative inotropic action on the isolated heart of frogs was noted. A vasodilative action in rabbits peripheral blood vessels and hypotension in anesthetized rabbits were remarkably recognized.

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Studies on the Efficacy of Combined Preparation of Crude Drugs(XXXI) -The Effect of Taeksa-tang on Diuresis, Serum Lipid, Isolated Ileum, Heart, Blood Vessel, Blood Pressure and Respiration- (생약(生藥) 복합제제(複合製劑)의 약효(藥效) 연구(硏究)(제31보)(第31報) -택사탕(澤瀉湯)이 이뇨(利尿), 고지혈증(高脂血症), 적출장관(摘出腸管), 적출심장(摘出心臟), 혈관(血管), 혈압(血壓) 및 호흡(呼吸)에 미치는 영향(影響)-)

  • Nam, Sang-Kyung;Lee, Dong-Suk;Kim, Nam-Jae;Lee, Kyung-Sup;Hong, Nam-Doo
    • Korean Journal of Pharmacognosy
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    • v.17 no.4
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    • pp.263-271
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    • 1986
  • In order to investigate experimentally the clinical effects of Taeksa-Tang that was prescribed to cure the severe dizziness, the water extract of Taeksa-Tang was experimented about the effects on the diuretic action, the serum lipid, the isolated ileum and heart, the blood vessel, the blood pressure and respiration. The results of this study were obtained as follows: The diuretic action was significantly shown in rabbits. The level of total cholesterol, triglyceride and phopholipid in serum of rabbits given high cholesterol diet were significantly decreased. The contraction of the isolated ileum of mice induced by acetylcholine chloride and barium chloride was remarkably inhibited. The vasodilating and hypotensive actions were noted in rabbits. Negative inotropic action on the isolated frog heart was recognized.

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Cardiac Transplantation; 1 Case Report (심장이식 1례보고)

  • 송명근
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.224-227
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    • 1993
  • We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

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