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J Thorac Cardiovasc Surg 2000;120:864-871
© 2000 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

Temporal endothelin dynamics of the myocardial interstitium and systemic circulation in cardiopulmonary bypass

From the Division of Cardiothoracic Surgery Research, Medical University of South Carolina, Charleston, SC.

This work was supported by National Heart, Lung, and Blood Institute grants HL-45024 and HL-56603 (F.G.S.). C. A. Walker is a Lifeline Foundation Student Research Fellow and was supported by a Novartis Medical Student Fellowship.

Received for publication Jan 11, 2000. Revisions requested March 27, 2000; revisions received May 1, 2000. Accepted for publication June 28, 2000. Address for reprints: Francis G. Spinale, MD, PhD, Cardiothoracic Surgery, Room 625, Strom Thurmond Research Building, PO Box 250778, 114 Doughty St, Charleston, SC 29425.

Abstract

Objective: Increased systemic levels of the bioactive peptide endothelin 1 during and after cardioplegic arrest and cardiopulmonary bypass have been well documented. However, endothelin 1 is synthesized locally, and therefore myocardial endothelin 1 production during and after cardiopulmonary bypass remains unknown.
Methods: Pigs (n = 11) were instrumented for cardiopulmonary bypass, and cardioplegic arrest was initiated. Myocardial interstitial and systemic arterial levels of endothelin 1 were measured before cardiopulmonary bypass, throughout bypass and cardioplegic arrest (90 minutes), and up to 90 minutes after separation from bypass. Myocardial interstitial endothelin 1 was determined by microdialysis and radioimmunoassay.
Results: Baseline myocardial endothelin 1 levels were higher than systemic endothelin 1 levels (25.6 ± 6.7 vs 8.3 ± 1.1 fmol/mL, P < .05). With the onset of bypass, myocardial endothelin 1 increased by 327% ± 92% from baseline (P < .05), which preceded the increase in systemic endothelin 1 levels.
Conclusion: Myocardial compartmentalization of endothelin 1 exists in vivo. Cardiopulmonary bypass and cardioplegic arrest induce temporal differences in endothelin 1 levels within the myocardial interstitium and systemic circulation, which, in turn, may influence left ventricular function in the postbypass period.

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