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Biomedical subjects

G J Wilson

Publications and source records attributed to G J Wilson.

At least 73 records · Page 4Linked to original sources

Inhibition of muscle force by vanadate.

Vanadate (Vi), an analogue of inorganic phosphate (Pi), is known to bind tightly with a long half life to the myosin MgATPase site, producing a complex which inhibits force. Both of these ligands bind to an actin.myosin.ADP state that follows the release of Pi in the enzymatic cycle, and their effects on muscle fibers and proteins in solution provide information on the properties of this state. The inhibition of active force generation began to occur at a [Vi] of 5 microM and was 90% complete at a [Vi] of 1 mM. Hill plots of the inhibition of force by Vi approximated that expected for a simple binding isotherm. Similar plots were obtained at both 25 degrees C and 5 degrees C. A simple binding isotherm is not expected to occur in a muscle fiber where steric constraints imposed by the intact filaments should introduce more complexity into the energetics of ligand binding. The inhibition of MgATPase activity for acto-subfragment-1 to 50% of controls occurred at a [Vi] which was only 20-fold higher than that required to inhibit force generation in fibers to the same level. Some models of actomyosin interactions would predict that the range of [Vi] required for complete force inhibition in fibers and the difference in the [Vi] required for inhibition in fibers and of myosin in solution would both be much larger.

Actins↗

Experience with repair of congenital heart defects using adjunctive endovascular devices.

The use of endovascular devices as an adjunct to repair of congenital heart anomalies represents a novel but unproven therapeutic approach. Intraoperative implantation of pulmonary arterial stents (5 to 15 mm diameter) was done in 11 patients with pulmonary atresia with ventricular septal defect (n = 4), classic tetralogy of Fallot (n = 2), truncus arteriosus (n = 1), hypoplastic left heart syndrome (stage II [n = 1] and stage III [n = 1] Norwood procedure), and miscellaneous pulmonary arterial stenoses (n = 3), as well as in patients with congenital (n = 1) and postoperative (n = 3) pulmonary venous obstruction and in 1 patient with combined pulmonary arterial and venous obstruction. The stents were effective at achieving immediate patency in all patients. There were two early deaths, one related to acute thrombosis of a small-diameter left pulmonary artery stent. Reintervention because of stent-related pulmonary arterial stenosis was frequently necessary. In five of seven patients who survived more than 1 month after implantation of stent size 8 mm or smaller severe stent-related pulmonary arterial obstruction developed. In four of the five patients with pulmonary vein stent implantation intractable obstruction developed, resulting in death in all three patients who had bilateral pulmonary vein stent implantation. Intraoperative occlusion of apical muscular ventricular septal defect with use of a clamshell device inserted from the right atrial approach was accomplished in four patients. One patient who underwent associated aortic arch reconstruction died as a result of left ventricular hypoplasia. The results in the remaining three patients were favorable on the basis of absence of significant late residual intraventricular shunting, left ventricular dysfunction, or arrhythmia. We conclude that recurrent intraluminal obstruction as a result of neointimal hyperplasia appears to be an eventual certainty in currently designed small-diameter endovascular stents. For this reason, we would recommend standard surgical techniques for repair of obstructive lesions of the pulmonary arterial confluence to maximize growth potential. Device occlusion of muscular ventricular septal defects is feasible but probably only indicated for complex cases of ventricular septal deficiency that otherwise necessitate a left ventriculotomy.

Adolescent↗

The effect of a braking device in reducing the ground impact forces inherent in plyometric training.

As a consequence of performing plyometric type exercises, such as depth jumps, impact forces placed on the musculoskeletal system during landing can lead to a potential for injury. A reduction of impact forces upon landing could therefore contribute to reduce the risk of injury. Twenty subjects performed a series of loaded jumps for maximal height, with and without a brake mechanism designed to reduce impact force during landing. The braked jumps were performed on the Plyometric Power System (PPS) with its braking mechanism set at 75% of body weight during the downward phase. The non-braked condition involved jumps with no braking. Vertical ground reaction force data, sampled for 5.5 s at 550 Hz from a Kistler forceplate, were collected for each jump condition. The following parameters were then calculated: peak vertical force, time to peak force, passive impact impulse and maximum concentric force. The brake served to significantly (p < 0.01) reduce peak impact force by 155% and passive impact impulse by 200%. No significant differences were found for peak concentric force production. The braking mechanism of the PPS significantly reduced ground impact forces without impeding concentric force production. The reduction in eccentric loading, using the braking mechanism, may reduce the incidence of injury associated with landings from high intensity plyometric exercises.

Adult↗

Group A streptococcal necrotizing fasciitis following varicella in children: case reports and review.

We report four cases of necrotizing fasciitis that occurred following varicella in children ranging in age from 2 to 8 years. The only organism isolated from each of these patients was Streptococcus pyogenes or group A beta-hemolytic Streptococcus (GABHS). Each child recovered; however, three required repeated surgical debridements in addition to therapy with antibiotics. An interesting finding in these patients was the development of hyponatremia and/or hypocalcemia. M-typing and T-typing of the isolates demonstrated that the GABHS strain in two children who attended the same school was M5; M1 and M3 strains were identified in the other two children. In addition to the children described in this series, eleven other cases of children with necrotizing fasciitis following varicella have been reported in the English-language literature since 1970. We believe that these cases provide further evidence that varicella is an important risk factor for necrotizing fasciitis that is caused by more-virulent strains of GABHS.

Chickenpox↗

Evidence that increases in lymphocyte tyrosine phosphorylation precede cardiac allograft rejection. Effects of cyclosporine and potential use in clinical management.

Tyrosine phosphorylation is an early, critical event in lymphocyte signal transduction. We measured tyrosine phosphorylation in a porcine experimental transplant model to evaluate its utility in monitoring the allograft immune response. Using flow cytometry, we demonstrate a biphasic increase in phosphotyrosine (ptyr) levels in peripheral blood mononuclear cells (PBMC), and that increases are detectable as early as 1 day posttransplantation in untreated transplanted animals (n = 4). This biphasic response is likely result from the sequestration of ptyr+ cells from the periphery into the graft as graft-infiltrating lymphocytic cells show increased ptyr levels. This suggests possible lymphocyte trafficking between the peripheral compartment and the allograft. A 5-day course of treatment with cyclosporine (CsA) at 20 mg/kg/day (n = 4), but not at 10 mg/kg/day (n = 4), prevents graft rejection in this allograft model. Strikingly, treatment with 20 mg/kg/day CsA, but not with 10 mg/kg/day, suppressed increases in ptyr levels in both PBMC and graft-infiltrating cells. Increases in ptyr levels in PBMC are detectable 2-5 days before histologic and electrocardiographic signs of graft rejection, suggesting a potential diagnostic utility for measuring tyrosine phosphorylation in monitoring and managing transplant rejection.

Animals↗

Development of a pericardial acellular matrix biomaterial: biochemical and mechanical effects of cell extraction.

There is evidence to suggest that the cellular components of homografts and bioprosthetic xenografts may contribute to calcification or immunogenic reactions. A four-step detergent and enzymatic extraction process has been developed to remove cellular components from bovine pericardial tissue. The process results in an acellular matrix material consisting primarily of elastin, insoluble collagen, and tightly bound glycosaminoglycans. Light and electron microscopy confirmed that nearly all cellular constituents are removed without ultrastructural evidence of damage to fibrous components. Collagen denaturation temperatures remained unaltered. Biochemical analysis confirmed the retention of collagen and elastin and some differential extraction of glycosaminoglycans. Low strain rate fracture testing and high strain rate viscoelastic characterization showed that, with the exception of slightly increased stress relaxation, the mechanical properties of the fresh tissue were preserved in the pericardial acellular matrix. Crosslinking of the material in glutaraldehyde or poly(glycidyl ether) produced mechanical changes consistent with the same treatments of fresh tissue. The pericardial acellular matrix is a promising approach to the production of biomaterials for heart valve or cardiovascular patching applications.

Animals↗

Use of the iso-inertial force mass relationship in the prediction of dynamic human performance.

The purpose of this investigation was to develop a new test of muscle function, termed the iso-inertial force-mass relationship, and to determine its relationship to dynamic physical performance in comparison to an isometric test. A group of 13 trained subjects performed an isometric, and a series of iso-inertial maximal upper body tests, in a bench press movement at loads of 30%, 60%, 100% (concentric) and 100%, 130% and 150% (eccentric) of maximum. Vertical forces exerted throughout the movement were recorded by a force plate. In addition, the subjects performed the following three performance tests: a maximal bench press, a seated shotput, and two drop bench-press throws from a height of 0.25 m, with loads of 10 kg and 30% of maximum. Correlation analysis demonstrated that in each instance the iso-inertial force mass tests were the best predictors of performance (r = 0.78-0.88) with both contraction type and mass specific effects apparent. Maximal isometric force and rate of force development were significantly related to some performance variables (r = 0.22-0.78). However, for all the performance movements assessed, the iso-inertial test modality recorded the highest relationship to performance. The difference in the relationship between performance and iso-inertial and isometric test modalities was particularly evident in the light load dynamic performance of the seated shotput (r = 0.86 vs r = 0.38, respectively). These results are explained in part by the neural and mechanical differences between iso-inertial and isometric muscle actions and their respective specificity to dynamic physical performance.

Adult↗

Tolerance of epicardial coronary endothelium and smooth muscle to hyperkalemia.

Results of previous studies have suggested that high K+ concentrations in cardioplegic solutions may be detrimental to coronary endothelium in perfused hearts, as determined from changes in the coronary flow rate, but the direct functional changes in endothelium secondary to hyperkalemia have not been fully studied. To determine the effect of the K+ concentration in a physiologic solution (Krebs') and in St. Thomas' cardioplegic solution, and the effect of exposure time on endothelium and smooth muscle, porcine coronary artery rings were set up in organ baths under a physiologic pressure. The effect of exposure to Krebs' solution containing 5.9 or 50 mmol/L K+ or to St. Thomas' solution containing 16 or 50 mmol/L K+, for either 2 hours (group I) or 4 hours (group II), was examined. The solutions were continuously aerated with 95% oxygen and 5% carbon dioxide to exclude the effects of ischemia and hypoxia. The rings were then washed and contracted with K+ (25 mmol/L). The ability to release endothelium-derived relaxing factor (EDRF) in response to an EDRF stimulus (substance P) was used as an index of endothelial function. Smooth muscle function was evaluated in terms of the K(+)-induced contraction force and the relaxation induced with glyceryl trinitrate, in addition to the maximal substance P-induced relaxation. The maximal relaxation induced by substance P did not decrease by incubation with 50 mmol/L K+ in any group (p > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Temperature dependence of the inhibitory effects of orthovanadate on shortening velocity in fast skeletal muscle.

We have investigated the effects of the orthophosphate (P(i)) analog orthovanadate (Vi) on maximum shortening velocity (Vmax) in activated, chemically skinned, vertebrate skeletal muscle fibers. Using new "temperature-jump" protocols, reproducible data can be obtained from activated fibers at high temperatures, and we have examined the effect of increased [Vi] on Vmax for temperatures in the range 5-30 degrees C. We find that for temperatures < or = 20 degrees C, increasing [Vi] inhibits Vmax; for temperatures > or = 25 degrees C, increasing [Vi] does not inhibit Vmax. Attached cross-bridges bound to Vi are thought to be an analog of the weakly bound actin-myosin.ADP-P(i) state. The data suggest that the weakly bound Vi state can inhibit velocity at low temperature, but not at high temperature, with the transition occurring over a narrow temperature range of < 5 degrees C. This suggests a highly cooperative interaction. The data also define a Q10 for Vmax of 2.1 for chemically skinned rabbit psoas fibers over the temperature range of 5-30 degrees C.

Actins↗

Conductance catheter measurements of left ventricular volume in the intact dog: parallel conductance is independent of left ventricular size.

OBJECTIVE: It has recently been suggested that conductance catheter parallel conductance (alpha Vc) is a function of left ventricular volume. To confirm this, alpha Vc was measured in this study over a wide range of steady state volumes. In addition, conductance derived volumes were compared to those obtained by radionuclide angiography to determine if the conductance catheter can be used to measure absolute left ventricular volume accurately in the intact dog heart. METHODS: Seven dogs were anaesthetised and instrumented with left ventricular conductance and pressure tip catheters, a flow through rho cuvette to continually measure blood resistance, a thermodilution catheter, and a venous catheter for volume infusion/withdrawal. Conductance and angiographic data were acquired at 8(SD 1) variably loaded states. Parallel conductance was measured twice at each state using a saline dilution technique and a new non-linear algorithm that allows variability in the observations of both maximum and minimum conductance volumes. RESULTS: The mean value of alpha Vc was 89.1(18.0) ml (71.8 to 111.3 ml) with a mean within-animal coefficient of variation of 7.3(3.4)%. Multiple linear regression using dummy variables to account for the large interanimal variability did not reveal any relationship between alpha Vc and either maximum or minimum left ventricular volume. Furthermore, no difference was found when alpha Vc values measured at the lowest and highest loading levels in each dog were compared. Linear regression showed good agreement between conductance and radionuclide derived end diastolic volumes (slope = 0.94, R = 0.9, p < 0.001). CONCLUSIONS: While alpha Vc varies between animals, it remains constant within any given animal over a broad range of left ventricular volumes. Thus the conductance catheter can provide reliable absolute left ventricular volume measurements under steady state conditions.

Animals↗

Musculotendinous stiffness: its relationship to eccentric, isometric, and concentric performance.

The purpose of this study was to quantify the relationship between musculotendinous stiffness and performance in eccentric, isometric, and concentric activities. Thirteen trained subjects performed a series of maximal effort eccentric, concentric, and isometric muscular contractions in a bench press-type movement. Additionally, subjects performed a series of quasi-static muscular contractions in a bench press movement. A brief perturbation was applied to the bar while these isometric efforts were maintained, and the resulting damped oscillations provided data pertaining to each subject's musculotendinous stiffness. Musculotendinous stiffness was significantly related to isometric and concentric performance (r = 0.57-0.78) but not to eccentric performance. These results are interpreted as demonstrating that the optimal musculotendinous stiffness for maximum concentric and isometric activities was toward the stiff end of the elasticity continuum. A stiffer musculotendinous unit may facilitate such performances by improving the force production capabilities of the contractile component, due to a combination of improved length and rate of shortening, and additionally by enhancing initial force transmission.

Adult↗

Dose-related effects of magnesium on myocardial function in the neonate.

The antagonistic effects of magnesium ion as a calcium ion blocker may decrease calcium influx associated with ischemia. However, the effect of magnesium on the preischemic neonatal myocardium has not been investigated previously. The purpose of this study was to investigate the effects of the administration of increasing doses of magnesium on left ventricular performance in the neonate. We assessed left ventricular function (pressure-volume data obtained by the conductance catheter/micromanometer technique) in three groups (n = 6 in each) of newborn pigs (3 to 5 days old) differing with respect to magnesium concentrations. End-systolic elastance did not change during infusion in group A (magnesium = 1.2 mmol/L), whereas in groups B (magnesium = 8 mmol/L) and C (magnesium = 16 mmol/L) it decreased significantly (P < .05) to 67 +/- 6% and 44 +/- 8% of baseline, respectively. The decrease in end-systolic elastance was associated with a significant reduction in cardiac output (P < .05) and stroke work (P < .05) in group C. After administration of magnesium, end-systolic elastance returned to baseline in group B in contrast to group C (78 +/- 3% of baseline value, P < .05). The slope constant of the end-diastolic pressure-volume relation decreased significantly (P < .05) from the preinfusion baseline values of 0.42 +/- 0.08 mL-1 in group B and 0.46 +/- 0.05 mL-1 in group C to 0.3 +/- 0.04 and 0.26 +/- 0.03 mL-1, respectively, versus no change in group A.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Heart rate independence of catecholamine-induced myocardial damage in the newborn pig.

Neonates undergoing heart surgery are exposed to high levels of circulating catecholamines. Our objective was to determine to what extent epinephrine (E)-related cardiotoxicity can be attributed to induced tachycardia. We assessed left ventricle function by pressure-volume data obtained by conductance catheter/micromanometer technique and correlated it with ultrastructure in newborn piglets (3 to 7 d old). Group A (n = 6) received E (1 microgram/kg/min) for 2 h, whereas group B piglets (n = 6) were atrially paced at a rate (220/min) matched to group A. Left ventricle peak systolic pressure and stroke work were significantly higher (p < 0.05) in group A. End-systolic elastance increased during E infusion (70%) versus no significant change in group B. After 2 h of E infusion, end-systolic elastance was significantly reduced in group A from 9.8 +/- 3.5 to 5 +/- 2.4 mm Hg/mL (p < 0.05). Chamber stiffness index increased during E infusion from 0.36 +/- 0.2 to 0.6 +/- 0.3 mL-1 (p < 0.05) and remained elevated (0.58 +/- 0.2 mL-1) after E infusion was discontinued versus no change in group B. E-induced left ventricle dysfunction was associated with scattered but irreversible ultrastructural changes consisting of sarcolemmal rupture and loss of mitochondrial architecture, whereas only minor reversible changes such as microvesicular lipid accumulation and mitochondrial swelling were seen in group B. We conclude that E cardiotoxicity in the neonate is independent of induced tachycardia.

Adenosine Triphosphate↗

In vitro and in vivo inhibition of rat vascular smooth muscle cell migration and proliferation by a 2-aminochromone U-86983.

Vascular smooth muscle cell migration and proliferation are the primary events that govern neointimal thickening and thus they determine the extent to which delayed restenosis occurs after percutaneous transluminal coronary angioplasty. In this study, the in vitro and in vivo smooth muscle cell antichemotactic and antiproliferative properties of a 2-aminochromone, 2-(4-morpholinyl)-8-(3-pyridinylmethoxy)-4H-1-benzopyran-4-one (U-86983), were examined. Migration and proliferation of early-passage rat vascular smooth muscle cells were inhibited by U-86983 in a concentration-dependent manner (IC50S, approximately 10 microM and 3.5 microM, respectively). Longer-term studies showed that the proliferation of smooth muscle cells was inhibited by U-86983 for at least 7 days and was fully reversible on removal of the drug. In addition, the effect of U-86983 on neointimal formation was examined in rats subjected to left common carotid artery balloon dilatation injury. Continual (2-week) i.v. administration of U-86983 (216 mg kg-1 day-1) resulted in a mean plasma drug concentration of 2.39 micrograms/ml (blood level, approximately 3.5 microM) and a 42% (P = .003) reduction in the neointima/media ratio of the injured artery. In agreement with the in vitro reversibility results, administration of U-86983 for only 2, 4 or 7 days did not affect significantly the neointimal thickness measured at 14 days, which indicated that the stimuli for smooth muscle cell migration and/or proliferation were still present 1 week after injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Comparison of ischaemic preconditioning in blood perfused and buffer perfused isolated heart models.

OBJECTIVE: The aim was to compare the effects of ischaemic preconditioning in the buffer perfused and parabiotic blood perfused Langendorff rabbit heart models. METHODS: Isolated hearts were perfused with either Krebs-Henseleit buffer solution or blood from a support rabbit. Hearts were subjected to an initial 30 min stabilisation period followed by 30 min of global ischaemia and 60 min of reperfusion. Ischaemic preconditioned (IP) hearts were also subjected to one cycle of 5 min global ischaemia and 10 min of reperfusion before the 30 min ischaemia. For each experiment, left ventricular function and necrosis were measured. RESULTS: Necrosis, as measured by tetrazolium staining and expressed as a percentage of the left ventricular area, was significantly different between the buffer perfused control [42.5% (SEM 6.9), n = 7] and buffer perfused IP group [22.2% (5.4), n = 7, p < 0.01]. In the blood perfused experiments, the IP group also had less necrosis [9.3% (3.1), n = 9] as compared to controls [22.9%(4.2), n = 9, p < 0.01]. The percentage reduction in necrosis produced by ischaemic preconditioning was not significantly different between the buffer perfused and blood perfused models. Peak left ventricular systolic pressure was not different between the control and IP hearts in either model at any time during the 60 min reperfusion period. In buffer perfused hearts, left ventricular end diastolic pressure at 60 min reperfusion was not significantly different between the IP and the control groups, at 34.3(5.5) mm Hg v 37.8(4.9) mm Hg, respectively. Similarly, there was no statistically significant difference in left ventricular end diastolic pressure in the blood perfused groups at this time: 13.3(2.8) in the IP group v 24.0(6.5) in controls. CONCLUSIONS: In isolated heart models of global ischaemia and reperfusion, in which both recovery of function and necrosis were assessed together, ischaemic preconditioning was highly effective in reducing necrosis in both blood perfused and buffer perfused models. However, ischaemic preconditioning did not significantly improve postischaemic recovery of function in either of the two preparations.

Animals↗

The optimal training load for the development of dynamic athletic performance.

This study was performed to determine which of three theoretically optimal resistance training modalities resulted in the greatest enhancement in the performance of a series of dynamic athletic activities. The three training modalities included 1) traditional weight training, 2) plyometric training, and 3) explosive weight training at the load that maximized mechanical power output. Sixty-four previously trained subjects were randomly allocated to four groups that included the above three training modalities and a control group. The experimental groups trained for 10 wk performing either heavy squat lifts, depth jumps, or weighted squat jumps. All subjects were tested prior to training, after 5 wk of training and at the completion of the training period. The test items included 1) 30-m sprint, 2) vertical jumps performed with and without a countermovement, 3) maximal cycle test, 4) isokinetic leg extension test, and 5) a maximal isometric test. The experimental group which trained with the load that maximized mechanical power achieved the best overall results in enhancing dynamic athletic performance recording statistically significant (P < 0.05) improvements on most test items and producing statistically superior results to the two other training modalities on the jumping and isokinetic tests.

Adult↗

Effects of high plasma epinephrine and Ca2+ concentrations on neonatal myocardial function after ischemia.

Administration of catecholamines to newborn infants may potentiate reperfusion injury because of increased transsarcolemmal Ca2+ influx and the presence of less developed sarcoplasmic reticulum in the immature hearts. We investigated the effect of administration of epinephrine (1.5 micrograms/kg per minute for 120 minutes) before ischemia and modified serum ionized Ca2+ concentrations in the cardioplegic solution and perfusate on postischemic left ventricular systolic and diastolic function in 25 piglets (5 to 7 days old) undergoing 90 minutes of cold blood cardioplegic arrest. The piglets were divided into four groups; Ca2+ 1.2 mmol/L, group A (n = 6), Ca2+ 0.25 mmol/L, group B (n = 6), Ca2+ 1.2 mmol/L and epinephrine, group C (n = 6), Ca2+ 0.25 mmol/L and epinephrine, group D (n = 7). Left ventricular function was assessed by a conductance catheter in the left ventricle measuring end-systolic and end-diastolic pressure-volume relationships during transient vena caval occlusion. By analysis of covariance, only Ca2+ concentration was important in predicting ventricular function recovery after ischemia (p < 0.01). End-systolic elastance decreased in all groups after ischemia; the magnitude was significantly greater in the normal groups (51% versus 35%, p < 0.01). There was a significant increase in the chamber stiffness index after administration of epinephrine before ischemia (p < 0.05). Groups with low Ca2+ perfusate (B and D) had no change in chamber stiffness index after ischemia. In contrast, there was a significant increase in chamber stiffness in the normal Ca2+ groups with (C) or without (A) epinephrine after ischemia (p < 0.05). Adenosine triphosphate stores declined significantly in the normal Ca2+ groups--48% versus 18% in the low Ca2+ groups (p < 0.01). We conclude that low Ca2+ concentrations in the perfusate and cardioplegic solutions better preserve left ventricular function in the normal and in epinephrine-stressed neonatal heart after ischemia.

Adenosine Triphosphate↗

The protective effect of magnesium on acute catecholamine cardiotoxicity in the neonate.

Neonates undergoing heart surgery are exposed to high levels of circulating catecholamines. Our objective was to determine to what extent administration of magnesium counters epinephrine-induced cardiotoxicity. We assessed left ventricular function (pressure-volume data obtained by the conductance catheter/micromanometer technique) and ultrastructure in newborn pigs 3 to 5 days of age before and after administration of epinephrine alone (2 micrograms/kg/min, group A, n = 6) and simultaneously with magnesium sulfate (8 mmol/L, 5 ml/hr, group B, n = 6). Plasma levels of magnesium were maintained at 200% to 250% of control, and ionized calcium was maintained at normal levels. During administration of epinephrine, there was a significant increase in end-systolic elastance from 8.9 +/- 2 to 15 +/- 3 mm Hg/ml in group A and from 7.8 +/- 2 to 16 +/- 3 mm Hg/ml in group B (p < 0.05). This increase was accompanied by an increase in chamber stiffness index (p < 0.05) and shortening of the time constant of isovolumic relaxation (p < 0.05; group A, 19 +/- 3 to 13 +/- 3 msec; Group B, 20 +/- 2 to 15 +/- 2 msec). After epinephrine was discontinued, however, systolic and diastolic indexes returned to baseline levels in group B, whereas group A exhibited a significant reduction in end-systolic elastance (5 +/- 1 mm Hg/ml; p < 0.05) and an increase in chamber stiffness index (0.7 +/- 0.08 versus 0.4 +/- 0.1 ml-1; p < 0.05) and time constant (25 +/- 1 versus 19 +/- 3 msec). Left ventricular dysfunction in group A was associated with focal sarcolemmal rupture and mitochondrial swelling, whereas only minor reversible changes (microvesicular lipid accumulation) were seen in group B. We conclude that magnesium has a protective effect against epinephrine-induced cardiotoxicity because of its blocking action on calcium influx of ionized calcium and could be of therapeutic benefit in the perioperative period.

Adenosine Triphosphate↗