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Biomedical subjects

H Berggren

Publications and source records attributed to H Berggren.

50 records · Page 3Linked to original sources
PubMed1983

Influence of noradrenaline and temperature on the isolated perfused rat heart.

Myocardial protection during open heart surgery is achieved by general cooling and cold cardioplegia. However sympathetic activation during the operation causes raised circulating catecholamine levels that might negatively influence the myocardial metabolism. Moreover, local liberation of catecholamines, in "poorly perfused' regions of the myocardium in patients with ischemic heart disease, might occur. In respect of these problems, we studied the influence of noradrenaline at different temperatures on the isolated perfused rat heart. The temperatures chosen were: 10, 20, 32, 37 and 39 degrees C. The results show clearcut adverse effect of noradrenaline at 32 degrees and higher, on metabolism and hemodynamic performance. At lower temperatures there still seem to be an adverse effect of noradrenaline although not statistically significant. The results of this study indicates the importance of presurgical myocardial protection especially of badly perfused myocardial areas. Such protection could be accomplished by beta-blockade and/or loading of the myocardium with glycogen by glucose-insulin-potassium infusion.

Animals↗
PubMed1983

Myocardial protective effect of maintained beta-blockade in aorto-coronary bypass surgery.

Twenty-nine patients were randomly allocated to two groups before undergoing aorto-coronary bypass surgery. In one group the beta-blocking medication was withdrawn three days preoperatively, and in the other group it was maintained. The patients in the latter group were additionally given 100 mg metoprolol per os two hours before surgery. The degree of myocardial injury, as judged from cumulated activity of S-CK B, was less when the beta-blockade was maintained.

Adrenergic beta-Antagonists↗
PubMed1982

Insulin sensitivity and glucose uptake in the course of surgical treatment for valvular aortic stenosis.

The dose-response relationship between plasma insulin and systemic glucose uptake was studied before, one hour after and 6 months after valvular surgery in 11 patients with valvular aortic stenosis. The immediate effect of valvular surgery was a dramatic rightward shift of the dose-response curve and a decrease in glucose uptake at peak insulin activity. From a comparison between the preoperative and the 6-month postoperative dose-response curves it is concluded that the patients had adapted metabolically to the preoperative haemodynamic situation with increased insulin sensitivity.

Aortic Valve Stenosis↗
PubMed1982

Effect of valvular aortic stenosis on insulin sensitivity.

18 patients with valvular aortic stenosis were given an i.v. glucose tolerance test and an i.v. insulin tolerance test before and 4-36 months after valve replacement. Insulin and C-peptide response to the glucose challenge was smaller preoperatively whereas the glucose response was the same pre- and postoperatively. The effect on blood glucose of the i.v. insulin challenge was more pronounced preoperatively. It is concluded that insulin sensitivity was increased preoperatively and it is suggested that this was a metabolic adaptation to the haemodynamic situation in aortic stenosis, which may have implications for preoperative glucose-insulin-potassium treatment.

Aged↗
PubMed1980

Thermographic demonstration of uneven myocardial cooling in patients with coronary lesions.

Low temperature is an important factor in protecting the myocardium during an operation on the heart. This can be difficult to accomplish if the cold cardioplegic solution is hindered by occlusions or stenosis of the coronary arteries. We used thermography to study myocardial temperature during infusion of cold cardioplegic solution. Slow cooling was recorded distal to coronary stenosis or occlusions, thereby indicating insufficient protection of the myocarium in these areas.

Aortic Valve Stenosis↗
PubMedDate not supplied

Centralization of pediatric heart surgery in Sweden.

In Sweden, which has a population of 8.9 million people, pediatric heart surgery was previously performed in four cities. After a long, difficult process, centralization of pediatric heart surgery to two centers was achieved in 1993. The overall 30-day mortality for open-heart surgery on infants and children of 9.5% before the centralization (1988-1991) was reduced to 1.9% in 1995-1997. A causal relationship between the mortality rates before and after the centralization is impossible to prove. Heart surgery was concentrated to the two centers with the lowest surgical mortality, and the reduction in surgical mortality was observed over a short period of time which makes it likely that the centralization of the surgical activity promoted the improved results. During the later time period the amount of more complex surgery was clearly increased compared to that performed previously.

Cardiac Surgical Procedures↗