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Esmolol Added in Repeated, Cold, Oxygenated Blood Cardioplegia Improves Myocardial Function After Cardiopulmonary Bypass
Objective This study investigated if the β-receptor blocking agent esmolol, added to standard oxygenated blood cardioplegia, improved myocardial function after weaning from bypass. Design A block-randomized, blinded study. Setting A university laboratory. Participants Twenty anesthetized pigs, Norwe...
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| Published in: | Journal of cardiothoracic and vascular anesthesia 2015-06, Vol.29 (3), p.684-693 |
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| container_title | Journal of cardiothoracic and vascular anesthesia |
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| creator | Dahle, Geir O., MD Salminen, Pirjo-Riitta, MD Moen, Christian A., MD, PhD Eliassen, Finn, CCP Jonassen, Anne K., MSc, PhD Haaverstad, Rune, MD, PhD Matre, Knut, MSc, PhD Grong, Ketil, MD, PhD |
| description | Objective This study investigated if the β-receptor blocking agent esmolol, added to standard oxygenated blood cardioplegia, improved myocardial function after weaning from bypass. Design A block-randomized, blinded study. Setting A university laboratory. Participants Twenty anesthetized pigs, Norwegian Landrace. Interventions After cardiopulmonary bypass, cardiac arrest was induced with cold (12°C), oxygenated blood cardioplegia, enriched with either esmolol or vehicle, repeated every 20 minutes. After 100 minutes the heart was reperfused and weaned. Measurements and Main Results Left ventricular function was evaluated with pressure-volume loops, local myocardial function with multilayer strain and strain rate by epicardial short-axis tissue Doppler imaging. One hour after declamping, preload recruitable stroke work did not differ between groups, but increased to 72±3 mmHg in esmolol-treated animals v 57±4 mmHg (p |
| doi_str_mv | 10.1053/j.jvca.2014.09.017 |
| format | article |
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Design A block-randomized, blinded study. Setting A university laboratory. Participants Twenty anesthetized pigs, Norwegian Landrace. Interventions After cardiopulmonary bypass, cardiac arrest was induced with cold (12°C), oxygenated blood cardioplegia, enriched with either esmolol or vehicle, repeated every 20 minutes. After 100 minutes the heart was reperfused and weaned. Measurements and Main Results Left ventricular function was evaluated with pressure-volume loops, local myocardial function with multilayer strain and strain rate by epicardial short-axis tissue Doppler imaging. One hour after declamping, preload recruitable stroke work did not differ between groups, but increased to 72±3 mmHg in esmolol-treated animals v 57±4 mmHg (p<0.001) in controls after 3 hours. Radial peak ejection strain rate also was increased by esmolol; 6.0±1.0 s−1 v 2.9±0.3 s−1 (p<0.001) in subendocardium and 3.9±0.5 s−1 v 2.3±0.2 s−1 (p<0.005) in the midmyocardium. Cardiac index was increased, 4.0±0.2 L/min/m2 by esmolol v 3.3±0.1 L/min/m2 for controls (p<0.05). Isovolumetric relaxation time constant was reduced by esmolol, 23±1 ms v 26±1 ms (p<0.025). Troponin-T did not differ and was 339±48 ng/L for the esmolol group and 357±55 ng/L for the control group (p = 0.81). Conclusions Esmolol added to blood cardioplegia preserved systolic cardiac function during the first 3 hours after reperfusion in a porcine model with 100 minutes of cardioplegic arrest.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2014.09.017</identifier><identifier>PMID: 25575405</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adrenergic beta-1 Receptor Antagonists - administration & dosage ; Adrenergic beta-1 Receptor Antagonists - metabolism ; Anesthesia & Perioperative Care ; Animals ; beta-blockade ; cardiac function ; cardioplegia ; Cardioplegic Solutions - administration & dosage ; Cardioplegic Solutions - metabolism ; cardiopulmonary bypass ; Cardiopulmonary Bypass - methods ; Cardiopulmonary Bypass - trends ; Cold Temperature ; Critical Care ; esmolol ; Female ; Heart Arrest, Induced - methods ; Heart Arrest, Induced - trends ; Male ; Oxygen - administration & dosage ; Oxygen - metabolism ; Propanolamines - administration & dosage ; Propanolamines - metabolism ; Random Allocation ; Swine</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2015-06, Vol.29 (3), p.684-693</ispartof><rights>The Authors</rights><rights>2015 The Authors</rights><rights>Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-aa9b605d5d51dc1ee102c4619ccfe3843531a744393be2ee932017f3828da0fe3</citedby><cites>FETCH-LOGICAL-c455t-aa9b605d5d51dc1ee102c4619ccfe3843531a744393be2ee932017f3828da0fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25575405$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dahle, Geir O., MD</creatorcontrib><creatorcontrib>Salminen, Pirjo-Riitta, MD</creatorcontrib><creatorcontrib>Moen, Christian A., MD, PhD</creatorcontrib><creatorcontrib>Eliassen, Finn, CCP</creatorcontrib><creatorcontrib>Jonassen, Anne K., MSc, PhD</creatorcontrib><creatorcontrib>Haaverstad, Rune, MD, PhD</creatorcontrib><creatorcontrib>Matre, Knut, MSc, PhD</creatorcontrib><creatorcontrib>Grong, Ketil, MD, PhD</creatorcontrib><title>Esmolol Added in Repeated, Cold, Oxygenated Blood Cardioplegia Improves Myocardial Function After Cardiopulmonary Bypass</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>Objective This study investigated if the β-receptor blocking agent esmolol, added to standard oxygenated blood cardioplegia, improved myocardial function after weaning from bypass. Design A block-randomized, blinded study. Setting A university laboratory. Participants Twenty anesthetized pigs, Norwegian Landrace. Interventions After cardiopulmonary bypass, cardiac arrest was induced with cold (12°C), oxygenated blood cardioplegia, enriched with either esmolol or vehicle, repeated every 20 minutes. After 100 minutes the heart was reperfused and weaned. Measurements and Main Results Left ventricular function was evaluated with pressure-volume loops, local myocardial function with multilayer strain and strain rate by epicardial short-axis tissue Doppler imaging. One hour after declamping, preload recruitable stroke work did not differ between groups, but increased to 72±3 mmHg in esmolol-treated animals v 57±4 mmHg (p<0.001) in controls after 3 hours. Radial peak ejection strain rate also was increased by esmolol; 6.0±1.0 s−1 v 2.9±0.3 s−1 (p<0.001) in subendocardium and 3.9±0.5 s−1 v 2.3±0.2 s−1 (p<0.005) in the midmyocardium. Cardiac index was increased, 4.0±0.2 L/min/m2 by esmolol v 3.3±0.1 L/min/m2 for controls (p<0.05). Isovolumetric relaxation time constant was reduced by esmolol, 23±1 ms v 26±1 ms (p<0.025). Troponin-T did not differ and was 339±48 ng/L for the esmolol group and 357±55 ng/L for the control group (p = 0.81). Conclusions Esmolol added to blood cardioplegia preserved systolic cardiac function during the first 3 hours after reperfusion in a porcine model with 100 minutes of cardioplegic arrest.</description><subject>Adrenergic beta-1 Receptor Antagonists - administration & dosage</subject><subject>Adrenergic beta-1 Receptor Antagonists - metabolism</subject><subject>Anesthesia & Perioperative Care</subject><subject>Animals</subject><subject>beta-blockade</subject><subject>cardiac function</subject><subject>cardioplegia</subject><subject>Cardioplegic Solutions - administration & dosage</subject><subject>Cardioplegic Solutions - metabolism</subject><subject>cardiopulmonary bypass</subject><subject>Cardiopulmonary Bypass - methods</subject><subject>Cardiopulmonary Bypass - trends</subject><subject>Cold Temperature</subject><subject>Critical Care</subject><subject>esmolol</subject><subject>Female</subject><subject>Heart Arrest, Induced - methods</subject><subject>Heart Arrest, Induced - trends</subject><subject>Male</subject><subject>Oxygen - administration & dosage</subject><subject>Oxygen - metabolism</subject><subject>Propanolamines - administration & dosage</subject><subject>Propanolamines - metabolism</subject><subject>Random Allocation</subject><subject>Swine</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp9kUtr3DAUhU1paNK0f6CLomUXtaOnH1AKkyEvSAj0Ad0JjXQd5MqWK9lD_O8rM0kXXQSBrpC-c3R1lGUfCC4IFuysK7q9VgXFhBe4KTCpXmUnRDCa15zS12mdqBxXFT7O3sbYYUyIENWb7JimIjgWJ9njRey98w5tjAGD7IC-wQhqAvMZbb1L8_3j8gDDuoPOnfcGbVUw1o8OHqxCN_0Y_B4iulu8Xg-UQ5fzoCfrB7RpJwjP_Ox6P6iwoPNlVDG-y45a5SK8f6qn2c_Lix_b6_z2_upmu7nNNRdiypVqdiUWJg1iNAEgmGpekkbrFljNmWBEVZyzhu2AAjQsxVG1rKa1UTghp9mng2_q888McZK9jRqcUwP4OUpS1kxUZVOJhNIDqoOPMUArx2D71LIkWK5Zyk6uics1cYkbmW5Koo9P_vOuB_NP8hxxAr4cAEiv3FsIMmoLgwZjA-hJGm9f9v_6n1w7O1it3G9YIHZ-DkPKTxIZqcTy--qzfjnhGHNR_mJ_ARBjp8U</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Dahle, Geir O., MD</creator><creator>Salminen, Pirjo-Riitta, MD</creator><creator>Moen, Christian A., MD, PhD</creator><creator>Eliassen, Finn, CCP</creator><creator>Jonassen, Anne K., MSc, PhD</creator><creator>Haaverstad, Rune, MD, PhD</creator><creator>Matre, Knut, MSc, PhD</creator><creator>Grong, Ketil, MD, PhD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150601</creationdate><title>Esmolol Added in Repeated, Cold, Oxygenated Blood Cardioplegia Improves Myocardial Function After Cardiopulmonary Bypass</title><author>Dahle, Geir O., MD ; Salminen, Pirjo-Riitta, MD ; Moen, Christian A., MD, PhD ; Eliassen, Finn, CCP ; Jonassen, Anne K., MSc, PhD ; Haaverstad, Rune, MD, PhD ; Matre, Knut, MSc, PhD ; Grong, Ketil, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-aa9b605d5d51dc1ee102c4619ccfe3843531a744393be2ee932017f3828da0fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adrenergic beta-1 Receptor Antagonists - administration & dosage</topic><topic>Adrenergic beta-1 Receptor Antagonists - metabolism</topic><topic>Anesthesia & Perioperative Care</topic><topic>Animals</topic><topic>beta-blockade</topic><topic>cardiac function</topic><topic>cardioplegia</topic><topic>Cardioplegic Solutions - administration & dosage</topic><topic>Cardioplegic Solutions - metabolism</topic><topic>cardiopulmonary bypass</topic><topic>Cardiopulmonary Bypass - methods</topic><topic>Cardiopulmonary Bypass - trends</topic><topic>Cold Temperature</topic><topic>Critical Care</topic><topic>esmolol</topic><topic>Female</topic><topic>Heart Arrest, Induced - methods</topic><topic>Heart Arrest, Induced - trends</topic><topic>Male</topic><topic>Oxygen - administration & dosage</topic><topic>Oxygen - metabolism</topic><topic>Propanolamines - administration & dosage</topic><topic>Propanolamines - metabolism</topic><topic>Random Allocation</topic><topic>Swine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dahle, Geir O., MD</creatorcontrib><creatorcontrib>Salminen, Pirjo-Riitta, MD</creatorcontrib><creatorcontrib>Moen, Christian A., MD, PhD</creatorcontrib><creatorcontrib>Eliassen, Finn, CCP</creatorcontrib><creatorcontrib>Jonassen, Anne K., MSc, PhD</creatorcontrib><creatorcontrib>Haaverstad, Rune, MD, PhD</creatorcontrib><creatorcontrib>Matre, Knut, MSc, PhD</creatorcontrib><creatorcontrib>Grong, Ketil, MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dahle, Geir O., MD</au><au>Salminen, Pirjo-Riitta, MD</au><au>Moen, Christian A., MD, PhD</au><au>Eliassen, Finn, CCP</au><au>Jonassen, Anne K., MSc, PhD</au><au>Haaverstad, Rune, MD, PhD</au><au>Matre, Knut, MSc, PhD</au><au>Grong, Ketil, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Esmolol Added in Repeated, Cold, Oxygenated Blood Cardioplegia Improves Myocardial Function After Cardiopulmonary Bypass</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>29</volume><issue>3</issue><spage>684</spage><epage>693</epage><pages>684-693</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Objective This study investigated if the β-receptor blocking agent esmolol, added to standard oxygenated blood cardioplegia, improved myocardial function after weaning from bypass. Design A block-randomized, blinded study. Setting A university laboratory. Participants Twenty anesthetized pigs, Norwegian Landrace. Interventions After cardiopulmonary bypass, cardiac arrest was induced with cold (12°C), oxygenated blood cardioplegia, enriched with either esmolol or vehicle, repeated every 20 minutes. After 100 minutes the heart was reperfused and weaned. Measurements and Main Results Left ventricular function was evaluated with pressure-volume loops, local myocardial function with multilayer strain and strain rate by epicardial short-axis tissue Doppler imaging. One hour after declamping, preload recruitable stroke work did not differ between groups, but increased to 72±3 mmHg in esmolol-treated animals v 57±4 mmHg (p<0.001) in controls after 3 hours. Radial peak ejection strain rate also was increased by esmolol; 6.0±1.0 s−1 v 2.9±0.3 s−1 (p<0.001) in subendocardium and 3.9±0.5 s−1 v 2.3±0.2 s−1 (p<0.005) in the midmyocardium. Cardiac index was increased, 4.0±0.2 L/min/m2 by esmolol v 3.3±0.1 L/min/m2 for controls (p<0.05). Isovolumetric relaxation time constant was reduced by esmolol, 23±1 ms v 26±1 ms (p<0.025). Troponin-T did not differ and was 339±48 ng/L for the esmolol group and 357±55 ng/L for the control group (p = 0.81). Conclusions Esmolol added to blood cardioplegia preserved systolic cardiac function during the first 3 hours after reperfusion in a porcine model with 100 minutes of cardioplegic arrest.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25575405</pmid><doi>10.1053/j.jvca.2014.09.017</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adrenergic beta-1 Receptor Antagonists - administration & dosage Adrenergic beta-1 Receptor Antagonists - metabolism Anesthesia & Perioperative Care Animals beta-blockade cardiac function cardioplegia Cardioplegic Solutions - administration & dosage Cardioplegic Solutions - metabolism cardiopulmonary bypass Cardiopulmonary Bypass - methods Cardiopulmonary Bypass - trends Cold Temperature Critical Care esmolol Female Heart Arrest, Induced - methods Heart Arrest, Induced - trends Male Oxygen - administration & dosage Oxygen - metabolism Propanolamines - administration & dosage Propanolamines - metabolism Random Allocation Swine |
| title | Esmolol Added in Repeated, Cold, Oxygenated Blood Cardioplegia Improves Myocardial Function After Cardiopulmonary Bypass |
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