l-arginine: effect on reperfusion injury after heart transplantation
Global myocardial ischemia and reperfusion injury play a major role in early postoperative myocardial graft dysfunction. The aim of the present study was to investigate the effects of the nitric oxide (NO) precursor l-arginine on myocardial and endothelial function after hypothermic ischemia and rep...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
01 August 1998
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| In: |
World journal of surgery
Year: 1998, Volume: 22, Issue: 8, Pages: 791-798 |
| ISSN: | 1432-2323 |
| DOI: | 10.1007/s002689900471 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s002689900471 Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1007/s002689900471 
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| Author Notes: | Gábor Szabó, Susanne Bährle, Sándor Bátkai, Nicole Stumpf, Thomas J. Dengler, Rainer Zimmermann, Christian F. Vahl, Siegfried Hagl |
| Summary: | Global myocardial ischemia and reperfusion injury play a major role in early postoperative myocardial graft dysfunction. The aim of the present study was to investigate the effects of the nitric oxide (NO) precursor l-arginine on myocardial and endothelial function after hypothermic ischemia and reperfusion in a heterotopic rat heart transplantation model. After 1 hour ischemic preservation, reperfusion was started after application of placebo (control, n= 12) or l-arginine (l-Arg 40 mg/kg, n= 12), a substrate of NO synthesis. Myocardial blood flow (MBF) was assessed by the hydrogen clearance method. An implanted balloon was used to obtain pressure-volume relations of the transplanted heart. Left ventricular developed pressure (LVDP), rate of pressure development (dP/dt), end-diastolic pressure (LVEDP), isovolumic relaxation constant (TE), and MBF were measured after 60 minutes and 24 hours of reperfusion. Endothelium-dependent vasodilatation in response to acetylcholine (ACh) and endothelium-independent vasodilatation in response to sodium nitroprusside (SNP) were also determined. After 1 hour the MBF was significantly higher in the l-Arg group (3.6 ± 0.6 vs. 1.9 ± 0.2 ml/min/g, p < 0.05). The l-Arg group showed better recovery of systolic function and myocardial relaxation (LVDP 106 ± 6 vs. 70 ± 7 mmHg, p < 0.05; maximal dP/dt 5145 ± 498 vs. 3410 ± 257 mmHg/s, p < 0.05; TE 12.1 ± 0.9 vs. 16.1 ± 1.5 ms, p < 0.05, at an intraventricular volume of 80 μl). LVEDP was similar in the two groups. After 24 hours no difference was found between the groups for basal MBF, LVP, dP/dt, TE, LVEDP, or the response of MBF to SNP. However, ACh led to a significantly higher increase in MBF in the l-Arg group (52 ± 8% vs. 29 ± 7%,p < 0.05). These results indicate that (1) NO donation improves myocardial and endothelial functional recovery during early reperfusion after heart transplantation; and (2) initial treatment with l-Arg has a persisting beneficial effect against reperfusion-induced graft coronary endothelial dysfunction during late reperfusion. |
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| Item Description: | Gesehen am 15.07.2025 |
| Physical Description: | Online Resource |
| ISSN: | 1432-2323 |
| DOI: | 10.1007/s002689900471 |