Biomedical subjects

L H Manciet

Publications and source records attributed to L H Manciet.

5 recordsLinked to original sources

PubMed1995

Left ventricular function after extended hypothermic preservation of the heart is dependent on functional coronary capillarity.

BACKGROUND: A growing body of knowledge has led to the hypothesis that injury to the microcirculation during hypothermic myocardial preservation may result in decreased contractility of hearts upon reperfusion. METHODS AND RESULTS: To test this hypothesis, we examined the relationship between no-reflow and left ventricular function after hypothermic cardiac preservation after reperfusion with solutions containing dilute whole blood (DWB) or washed red blood cells (K2RBC). Rat hearts were arrested with high-potassium cardioplegia, then flushed and stored for 6 hours in low-potassium cardioplegia at 4 degrees C. Hearts were reperfused at a constant flow rate (4 mL/min) with K2RBC for 60 minutes (group 1, n = 5) or DWB for 7 minutes followed by 53 minutes of K2RBC (group 2, n = 5). Left ventricular developed pressure (LVDP) was measured with an intraventricular balloon. Immediately after functional assessment, hearts were perfused with an india ink solution to mark flow, then glutaraldehyde. Morphometric techniques were used to determine the degree of capillary compression [delta d(c)], perfused capillary number per fiber area [QA(0)P], and perfused capillary surface area per fiber volume [Sv(c,f)P]. Capillaries were moderately compressed in both groups after reperfusion (group 1, 19 +/- 1%; group 2, 20 +/- 1%). QA(0)P and Sv(c,f)P were highly correlated with delta d(c) in hearts reperfused with K2RBC (r = .92 and r = .92; P < .01). Although statistically significant, the correlation was not as strong in DWB-reperfused hearts (r = .66 and r = .67; P < .05). LVDP was correlated to QA(0)P and Sv(c,f)P (r = .86 and r = .87, respectively) for groups 1 and 2. CONCLUSIONS: The weaker correlation between capillary perfusion and capillary compression in DWB-reperfused hearts suggests that factors other than compression contribute to no-reflow after hypothermic preservation. Regardless of the composition of the reperfusate, recovery of left ventricular function after hypothermic ischemia is directly related to coronary capillary perfusion upon reperfusion.

Animals↗

PubMed1994

Microvascular compression during myocardial ischemia: mechanistic basis for no-reflow phenomenon.

Alterations in fiber size and capillary diameter were highly correlated with perfusion deficits after myocardial ischemia. After 5 (n = 3) and 30 (n = 5) min of global normothermic ischemia, isolated rabbit hearts were perfused with India ink and then with glutaraldehyde. Morphometric techniques were used to determine mean fiber cross-sectional area [a(f)], mean effective capillary diameter [d(c)], total and perfused capillary number per fiber area, and capillary length per fiber volume in subepicardium (Epi) and subendocardium (Endo). Sarcomere length was measured to differentiate between effects of fiber shortening and intracellular edema on a(f). After 30 min of ischemia, a(f) increased 41 (Epi) and 36% (Endo). Of these percentages, fiber shortening accounted for 2 (Epi) and 25% (Endo). Decreased d(c) was correlated with increased a(f) as well as reductions in perfused capillary number and length. Whereas intracellular edema had the greatest overall effect on a(f), fiber shortening accounted for a significant increase of a(f) in Endo, where perfusion deficits were most pronounced. These data support the hypothesis that microvascular compression consequent to increased a(f) contributes to perfusion deficits after myocardial ischemia.

Animals↗

PubMed1992

Lipid peroxidation results in compromised functional recovery of isolated rabbit hearts after low-pressure, hypothermic, perfused preservation for 24 hours.

Low-pressure, hypothermic perfusion of isolated rabbit hearts for 24 hours compromises contractile function. This occurs despite continuous recirculation of an oxygenated solution. This investigation tested the hypothesis that such functional impairment results from irreversible tissue damage consequent to ischemia-induced lipid peroxidation. Decreases in coronary flow were measured during preservation and related to concentrations of thiobarbituric acid reactive species (TBA+, primarily malondialdehyde, a by-product of lipid peroxidation) in the tissue after preservation. The concentration of TBA+ species and the percent decrease in coronary flow rates at 30 minutes and 24 hours were positively correlated (r = 0.591 and r = 0.646, respectively). India ink was used as a marker of microvascular perfusion. Hearts showing the greatest magnitude of ischemia (evidenced by decreased percentages of perfused microvessels) had the highest levels of TBA+ species (r = 0.924). Moreover, hearts that had the highest levels of TBA+ species in the tissue exhibited the lowest levels of left ventricular function (as measured on a modified Langendorff apparatus; r = 0.767). We conclude that impaired coronary flow rates during perfused preservation portend compromised myocardial contractility. Furthermore, these changes occur largely within the first 30 minutes of perfusion. It is likely that early decrements in microvascular perfusion and consequent tissue injury owing to lipid peroxidation underlie impaired myocardial function after preservation.

Animals↗

PubMedDate not supplied

Capillary ultrastructure and functional capillary density.

We briefly summarize our findings on alterations in capillary structure in skeletal muscle and heart in response to up to 30 min of ischemia. In frog sartorius muscle, reactive hyperemia was absent in atrophy. Increased spatial heterogeneity of red cell velocity in individual capillaries was observed, as were increases in the percentage of capillaries with damaged endothelium and white cell volume density in capillaries. Examination of the effect of aging on the response of the vascular bed to 30 min ischemia in extensor digitorum longus muscle of Fisher 344 rats suggested that the lack of postischemic hyperemia and structural alterations in frog muscle were related to disuse rather than aging per se. However, the specific study of disuse in rat extensor digitorum longus muscle after chronic application of tetrodotoxin revealed both capillary damage and a postischemic hyperemic response. It suggested an effect of the degree of tissue deterioration on the hyperemic response after short-term disuse in rat muscle, compared to longer-term atrophy in frog. Morphometric data in isolated rabbit heart suggested a link between microvascular compression as a result of tissue edema and decreased perfusion after 30 min total ischemia.

Aging↗

PubMedDate not supplied

Low-pressure perfusion results in effective microvascular perfusion of isolated rabbit hearts during hypothermic preservation for twenty-four hours.

Hypothermic, low-pressure coronary artery perfusion with oxygenated electrolyte solutions containing oncotic agents has resulted in successful orthotopic transplantation of hearts after extended preservation periods. Coronary flow may not, however, be consistently maintained during preservation. Previous research has demonstrated that coronary flow during preservation is related to contractile function after preservation. Specific mechanisms leading to reduced coronary flow during preservation remain undefined. This study was designed to determine whether low-pressure perfusion is a mechanism for decreased coronary flow and decreased microvascular perfusion during preservation. With India ink used as a marker of flow, microvascular perfusion was measured in rabbit hearts immediately after isolation (controls) or after 24 hours of hypothermic perfusion at 13 mm Hg (preserved hearts). There were no differences in the percentage of perfused microvessels in the control hearts perfused at either 13 or 80 mm Hg (94% +/- 2% and 99% +/- 1%, respectively). Nor was there a difference in the percentage of perfused microvessels in hearts perfused at either 13 or 80 mm Hg after 24 hours of hypothermic, low-pressure perfused preservation (67% +/- 9% and 74% +/- 6%, respectively). There was a significant difference, however, between the percentage of perfused microvessels in control hearts and in hearts preserved for 24 hours. These differences were independent of the pressure at which the India ink solution was administered. A perfusion pressure of 13 mm Hg is as effective as is 80 mm Hg in providing perfusion of the coronary microvascular beds during long-term hypothermic perfused preservation.

Analysis of Variance↗