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dc.contributor.authorDahle, Geir Olav
dc.contributor.authorSalminen, Pirjo-Riitta
dc.contributor.authorMoen, Christian Arvei
dc.contributor.authorEliassen, Finn
dc.contributor.authorNygreen, Else Loholdt
dc.contributor.authorKytö, Ville
dc.contributor.authorSaukko, Pekka
dc.contributor.authorHaaverstad, Rune
dc.contributor.authorMatre, Knut
dc.contributor.authorGrong, Ketil
dc.date.accessioned2017-08-11T08:16:50Z
dc.date.available2017-08-11T08:16:50Z
dc.date.issued2016-08
dc.identifier.citationDahle GO, Salminen P, Moen CA, Eliassen F, Nygreen EL, Kytö, Saukko, Haaverstad R, Matre K, Grong K. Carvedilol-enriched cold oxygenated blood cardioplegia improves left ventricular diastolic function after weaning from cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia. 2016;30(4):859-868eng
dc.identifier.urihttp://hdl.handle.net/1956/16265
dc.description.abstract<p>Objectives: To investigate whether adding carvedilol, a nonselective &beta;- and selective &alpha;1-receptor blocking agent with antioxidant properties, to oxygenated blood cardioplegia improves myocardial function after weaning from bypass.</p> <p>Design: A randomized controlled study.</p> <p>Setting: A university laboratory.</p> <p>Participants: Twenty anesthetized pigs, Norwegian Landrace.</p> <p>Interventions: On cardiopulmonary bypass, cardiac arrest was induced with cold (12&deg;C), oxygenated blood cardioplegia, enriched with carvedilol or vehicle, and repeated every 20 minutes. After 100 minutes, the heart was reperfused and weaned.</p> <p>Measurements and Main Results: Left ventricular function was evaluated with pressure-volume loops, local myocardial systolic strain, and strain rate from Speckle tracking analysis and multilayer short-axis tissue Doppler Imaging. In the carvedilol group, the load-independent logarithmic end-diastolic pressure volume relationship, &beta;, decreased from 1 to 3 hours of reperfusion and was low, 0.028&plusmn;0.004 v 0.042&plusmn;0.007 (p&lt;0.05) in controls at 3 hours, demonstrating improved left ventricular compliance. The diastolic relaxation constant &tau; was decreased, 28.9&plusmn;0.6 ms v 34.6&plusmn;1.3 ms (pg&lt;0.035), and dP/dtmin was more negative,&minus;1,462&plusmn;145 mmHg/s v&minus;1,105&plusmn;105 mmHg/s (pg = 0.024), for carvedilol v control group. The systolic variables, preload recruitable stroke work and end-systolic pressure-volume relationship, did not differ between groups, neither did left ventricular systolic strain and strain rate. Myocardial oxidative stress, measured as tissue levels of malondialdehyde, was reduced by carvedilol, 0.19&plusmn;0.01 compared to 0.24&plusmn;0.01 nmol/mg (p = 0.004) in controls.</p> <p>Conclusions: Carvedilol added to blood cardioplegia improved diastolic cardiac function and reduced oxidative stress during the first 3 hours after reperfusion in a porcine model, with 100 minutes of cardioplegic arrest.</p>eng
dc.language.isoengeng
dc.publisherElseviereng
dc.rightsAttribution CC BY-NC-NDeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/eng
dc.subjectcarvediloleng
dc.subjectcardiac functioneng
dc.subjectcardioplegiaeng
dc.subjectcardiopulmonary bypasseng
dc.subjectoxidative stresseng
dc.titleCarvedilol-enriched cold oxygenated blood cardioplegia improves left ventricular diastolic function after weaning from cardiopulmonary bypasseng
dc.typeJournal articleeng
dc.date.updated2017-04-26T08:00:24Z
dc.rights.holderCopyright 2016 The Author(s)eng
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
dc.type.documentJournal article
dc.identifier.cristinID1441831
dc.identifier.doi10.1053/j.jvca.2016.03.152eng
dc.source.issn1053-0770eng
bora.bpoaIDbpoa761
dc.relation.journalJournal of Cardiothoracic and Vascular Anesthesia


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