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PubMed1994

Influence of joint injury on motor and functional recovery of finger replantation.

A series of 82 consecutive cases were studied concentrating on the influence of joint injury on the final motor and functional recovery of the successfully replanted or revascularized finger. In this series a 32.0% (41/128) incidence of joint injury was found. When the proximal interphalangeal (PIP) joint was injured and preservation was not possible, arthrodesis was done. This would cause a significantly lower Tamai's score (70.9), total active range of motion (TAM; 99.4 degrees) and TAM-minus the metacarpophalangeal joint TAM-MP; (15.6 degrees). The influence of arthrodesis on the distal interphalangeal (DIP) joint was relatively minor. When preservation of the joint was possible, the PIP arthroplasty group had a significantly higher Tamai's score (83.7, P < 0.01), TAM (157.9 degrees, P < 0.05), and TAM-MP (70.0 degrees, P < 0.001). Preservation of the DIP joint also significantly increased the TAM and TAM-MP degrees, yet with no significant improvement in Tamai's score. Our study proves what most hand surgeons would expect, in that sacrifices of the PIP and MP joint would cause a significantly detrimental effect on the functional recovery of a finger. We also recommend joint preservation during replantation surgery whenever possible, especially for the PIP and MP joints, in order to achieve better functional recovery of the finger.

Adolescent↗
PubMed1994

Micturition patterns after spinal trauma as a measure of autonomic functional recovery.

The purpose of these experiments was to determine whether experimental spinal trauma would result in urological dysfunction similar to that seen clinically and whether recovery of normal micturition can be correlated with motor functional recovery. A standard rat model of spinal impact trauma was employed. Neurologic evaluation included a modified 7 point hindlimb Tarlov scale applied weekly for 4 weeks after injury. Micturition measurement was accomplished by placing the animal in a metabolic cage for 24-hour periods and collecting urine on an electronic scale connected to Lotus Measure data acquisition software. All assessments were performed in a blinded fashion. Animals were categorized as normal control (N = 10), sham injured (N = 11), spinal cord injury (SCI) without (N = 11) and with locomotor recovery (N = 11). There were no differences in total micturition volume among the 4 groups, while the number of micturitions per 24 hours was significantly less for SCI without locomotor recovery (10.4 +/- 5.9) than for control (21.3 +/- 4.5). The volume per micturition was significantly greater for SCI (2.0 +/- 0.7 ml.) than for control (0.8 +/- 0.2 ml.). There were no differences among groups in the ratio of number of micturitions night/day. The SCI group had significantly greater largest and smallest micturitional volumes. Results clearly show alterations in micturition patterns induced by SCI. These were proportional to, but did not correlate fully with, the severity of injury and degree of motor recovery. Thus, recovery of a normal micturition pattern did not occur to the same extent as did motor functional recovery. This difference underscores the potential value of autonomic measures of SCI for distinguishing outcome categories after experimental SCI.

Analysis of Variance↗
PubMed2001

Effects of N-nitropyrazoles on ocular blood flow of rabbits and retinal function recovery of rat eyes after ischemic insults.

Twelve compounds of N-nitropyrazoles were studied for their effects on ocular blood flow in rabbits and retinal function recovery in rat eyes after ischemic insults. Of the twelve N-nitropyrazoles examined, nine increased choroidal blood flow while five increased retinal blood flow significantly. On the other hand, all twelve compounds increased blood flow in iris and ciliary muscle without exception. As for retinal function recovery after ischemic insult in rat eyes, eight out of the twelve compounds showed more significant facilitation than the control. The structure activity relationship of the N-nitropyrazoles to increase ocular blood flow and to facilitate retinal function recovery after ischemic insults were discussed.

Animals↗
PubMed2006

The effects of lateralized training on spontaneous forelimb preference, lesion deficits, and graft-mediated functional recovery after unilateral striatal lesions in rats.

The ability of striatal embryonic grafts to promote functional recovery on complex behavioral tasks depends on various factors, including the amount of striatal-like tissue within the grafts and the duration of post-graft training. However, how the innate paw bias of animals is affected by experience, or influences recovery following injury, is less known. Here, we have examined the effects of intrinsic side bias and lateralized limb use training on spontaneous forelimb preference and graft-mediated functional recovery in a skilled reaching task in a rodent model of Huntington's disease. Naïve rats were assessed on their baseline paw preferences when reaching between the bars of their cage to retrieve sugar pellets from a tray attached outside. Next, rats were lesioned unilaterally in the lateral dorsal striatum with quinolinic acid, and 7-10 days later, half of the animals were given suspension grafts prepared from E15 whole ganglionic eminence implanted into the lesioned striatum. The animals then received extensive unilateral training, either ipsi- or contralateral to the side of the lesion and graft in separate subgroups, on the 'staircase' task until asymptotic performance was obtained. As reported previously, the grafts alleviated lesion-induced deficits in retrieving pellets from the contralateral staircase. Spontaneous biases were then reassessed in the cage-reaching task. Irrespective of whether the animal received ipsilateral or contralateral staircase training, the unilateral lesions induced a significant shift in spontaneous bias towards the ipsilateral paw. Grafted animals showed a similar shift in bias if staircase training was given to the ipsilateral paw but showed no change in spontaneous bias (similar to controls) if they had received contralateral training during the post-transplantation period. The results suggest that striatal grafts can alleviate lesion-induced changes in their spontaneous side preferences, but only if they receive extensive training in the use of the contralateral limb, compatible with the notion that recovery is use-dependent.

Animals↗
PubMedDate not supplied

Functional recovery of hearing following ampa-induced reversible disruption of hair cell afferent synapses in the avian inner ear.

Hair cells in the avian inner ear can regenerate after acoustic trauma or ototoxic insult, and significant functional recovery from hearing loss occurs. However, small residual deficits remain, possibly as a result of incomplete reestablishment of the hair cell neural synaptic contacts. The aim of the present study was to determine if intracochlear application of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA), an excitotoxic glutamate agonist, causes reversible disruption of hair cell neural contacts in the bird, and to what extent functional recovery occurs if synaptic contacts are reestablished. Compound action potential (CAP) responses to tone bursts were recorded to determine hearing thresholds during a recovery period of up to 4 months. Subsequently, the response properties of single auditory nerve fibers were analyzed in the same animals. Instillation of AMPA into the perilymph of the scala tympani led to immediate abolition of CAP thresholds. Partial recovery occurred over a period of 2-3 weeks, without further improvement of thresholds thereafter. High-frequency thresholds did not reach control values even after 3-4 months of recovery. Single-ganglion cell response properties, obtained 3-4 months after AMPA treatment, showed elevated thresholds at the fiber's characteristic frequency (CF) for units with CF above 0.3 kHz. Sharpness of tuning (Q(10 dB)) was reduced in units with CF above 0.4 kHz. The spontaneous firing rate was higher in units with CF above 0.18 kHz. The maximum sound-evoked discharge rate was also increased. Transmission electron micrographs of the basilar papilla showed that, following AMPA treatment, the nerve endings went through a sequence of swelling, degeneration and recovery over a period of 3-7 days. The process of neosynaptogenesis was completed 14 days after exposure. The present findings are strong evidence for a role of glutamate or a related excitatory amino acid as the afferent transmitter in the avian inner ear. In addition they show that functional recovery after disruption and regeneration of hair cell neural synapses, without apparent damage to the hair cells, is incomplete.

Animals↗
PubMed2003

Enhanced functional recovery after proximal nerve root injury by vector-mediated gene transfer.

In order to test the functional implication of herpes simplex virus (HSV) vector-mediated gene transfer after axonal injury, we injected replication-incompetent HSV vectors coding for the anti-apoptotic peptide Bcl-2 and the glial cell-derived neurotrophic factor (GDNF), separately or in combination into ventral spinal cord 30 min after a crush injury to the proximal spinal root that was combined with moderate mechanical traction. HSV-mediated expression of Bcl-2 or GDNF enhanced functional recovery assessed by histologic, electrophysiologic, and behavioral parameters up to 5 months after injury. The most sensitive measure of distal motor function, the sciatic function index, was significantly improved in animals injected with the two vectors together. These results suggest an approach to root trauma that might be used to enhance functional recovery after injury.

Animals↗
PubMed2005

Detection of functional recovery using low-dose dobutamine and myocardial contrast echocardiography after acute myocardial infarction treated with successful thrombolytic therapy.

OBJECTIVE: We studied the value of low-dose dobutamine stress echocardiography (LDDE) and myocardial contrast echocardiography (MCE) in early prediction of left ventricular functional recovery (LVFR) after acute myocardial infarction (AMI) treated with successful thrombolysis. DESIGN: LDDE and MCE using second-harmonic intermittent imaging were performed in first week after AMI. LVFR was defined as an absolute > or =5% increase in ejection fraction, from early to 6 months of follow-up by Technetium-99m-Sestamibi single-photon emission computed tomography. PATIENTS: Out of 50 patients studied, 19 evolved with LVFR (group 1) and 31 without LVFR (group 2). Regional dysfunction was detected in 103 (37%) infarcted-related segments in group 1 and in 173 (63%) segments in group 2. RESULTS: Sensitivity, specificity, positive, and negative predictive values and accuracy for detecting LVFR by LDDE were 94.7% (18/19), 87.1% (27/31), 81.8% (18/22), 96.4% (27/28), and 90% (45/50), respectively, and by MCE were 94.7% (18/19), 51.6% (16/31), 54.5% (18/33), 94.1% (16/17), and 68% (34/50). In group 1, functional improvement was observed in 86.9% (53/61) of segments with contractile reserve by LDDE and in 65.8% (52/79) of segments with microvascular perfusion by MCE. In group 2, functional improvement was observed in 78.3% (18/23) of segments with contractile reserve by LDDE and in 25.5% (25/98) of segments with microvascular perfusion by MCE. All segments without perfusion by MCE evolved without functional recovery. CONCLUSION: LDDE was an accurate predictor of late left ventricular function recovery after AMI, while MCE was sensitive and has a high negative predictive value demonstrating that microvascular perfusion is essential for LVFR.

Aged↗
PubMed2002

Combined effects of fasting and alanine on liver function recovery after cold ischemia.

The effect of donor nutritional status on hepatic function recovery after cold ischemia is still debated. We demonstrated previously that a 48-h fast diminished the survival rate of liver-transplanted rats and that the deleterious effect of fasting was prevented by infusion of alanine to the recipient at reperfusion. Whether the duration of fasting influenced the protective effect of alanine and whether this effect was metabolic were not known, and the elucidation of these questions is the aim of this study. The effect on hepatic function recovery of fasting periods of 24 h, 48 h and 72 h prior to cold ischemia were studied in a model of isolated, perfused rat liver. After a cold-ischemic time of 24 h in University of Wisconsin (UW) solution at 4 degrees C, livers were reperfused for 3 h. The combined effect of alanine (8 mM) infusion at liver reperfusion was evaluated for each prior fasting period. The addition of pyruvate (8 mM), a metabolic intermediary of alanine, was only tested in the 72-h fasting group. The evaluation criteria were: liver weight after reperfusion, release of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) in the perfusate, bile production, vascular resistance and liver histology after reperfusion. The enzyme release at reperfusion was significantly higher when livers were harvested from rats submitted to a 48-h fast (ALT) or a 72-h fast (ALT, AST, LDH), as compared to those from fed rats. Vascular resistance was increased in 72-h fasted livers. An addition of alanine (8 mM) at reperfusion lowered the release of AST, ALT and LDH. This effect was more obvious when the fasting duration was increased. By contrast, the addition of pyruvate at reperfusion did not improve the recovery of livers submitted to a 72-h fasting period before preservation. A long fasting period is deleterious as compared to feeding; however, this effect can be compensated by infusion of alanine at reperfusion. The mechanism involved is not metabolic. In a clinical setting, the infusion of alanine to the recipient at reperfusion may be a convenient way to compensate for donor undernutrition, especially after a long stay in an intensive care unit.

Alanine↗
PubMed1996

Brain-derived neurotrophic factor and collagen tubulization enhance functional recovery after peripheral nerve transection and repair.

OBJECTIVE: To investigate the effect of brain-derived neurotrophic factor (BDNF) and collagen tubulization (CT) on the regeneration of transected peripheral nerves. METHODS AND DESIGNS: The left sciatic nerve of 40 Sprague-Dawley rats was transected then repaired using one of four techniques; epineurial coaptation, CT, CT with BDNF delivered by an osmotic pump to the repair site, or CT with BDNF covalently cross-linked to the collagen matrix (CT/linked-BDNF). Sciatic functional indices were measured preoperatively at 10-day intervals for 90 days. Segments of the sciatic nerves proximal and distal to the repair site were harvested at 90 days for histologic and morphometric evaluation. RESULTS: Animals repaired by CT/linked-BDNF (n=10) demonstrated the most favorable functional recovery of all groups, with statistically significant differences seen compared with animals repaired by CT (n=10, P=.05) and epineural coaptation (n=9, P<.001). Animals repaired by CT with BDNF delivered by an osmotic pump (n=8) and CT also showed statistically superior functional recovery compared with those repaired by epineurial coaptation (P=.005 and P=.02, respectively). Nerves repaired by CT/linked-BDNF had the largest mean axon diameters proximal and distal to the repair site. CONCLUSION: Brain-derived neurotrophic factor and CT improve the rate and the degree to which recovery of sciatic function occurs after nerve transection and repair. Animals repaired by CT/BDNF-linked demonstrated the most favorable functional recovery of all groups. Animals whose repair technique included BDNF had the largest mean axon diameters of all groups.

Animals↗
PubMed2007

Glucose and insulin improve cardiac efficiency and postischemic functional recovery in perfused hearts from type 2 diabetic (db/db) mice.

Hearts from type 2 diabetic (db/db) mice demonstrate altered substrate utilization with high rates of fatty acid oxidation, decreased functional recovery following ischemia, and reduced cardiac efficiency. Although db/db mice show overall insulin resistance in vivo, we recently reported that insulin induces a marked shift toward glucose oxidation in isolated perfused db/db hearts. We hypothesize that such a shift in metabolism should improve cardiac efficiency and consequently increase functional recovery following low-flow ischemia. Hearts from db/db and nondiabetic (db/+) mice were perfused with 0.7 mM palmitate plus either 5 mM glucose (G), 5 mM glucose and 300 microU/ml insulin (GI), or 33 mM glucose and 900 microU/ml insulin (HGHI). Substrate oxidation and postischemic recovery were only moderately affected by GI and HGHI in db/+ hearts. In contrast, GI and particularly HGHI markedly increased glucose oxidation and improved postischemic functional recovery in db/db hearts. Cardiac efficiency was significantly improved in db/db, but not in db/+ hearts, in the presence of HGHI. In conclusion, insulin and glucose normalize cardiac metabolism, restore efficiency, and improve postischemic recovery in type 2 diabetic mouse hearts. These findings may in part explain the beneficial effect of glucose-insulin-potassium therapy in diabetic patients with cardiac complications.

Animals↗
PubMed2005

Oxidized galectin-1 advances the functional recovery after peripheral nerve injury.

Oxidized galectin-1 has been shown to promote axonal regeneration from transected-nerve sites in an in vitro dorsal root ganglion (DRG) explant model as well as in in vivo peripheral nerve axotomy models. The present study provides evidence that oxidized galectin-1 advances the restoration of nerve function after peripheral nerve injury. The sciatic nerve of adult rats was transected and the distal nerve was frozen after being sutured into a proximal site with four epineurial stitches. An osmotic pump delivered oxidized galectin-1 peripherally to the surgical site. Functional recovery was assessed by measurement of the degree of toe spread of the hind paw for 3 months after the sciatic nerve lesion. The recovery curves of toe spread in the test group showed a statistically significant improvement of functional recovery after day 21 by the application of oxidized recombinant human galectin-1 (rhGAL-1/Ox) compared to the control group. This functional recovery was supported by histological analysis performed by light microscopic examination. The regenerating myelinated fibers at the site 21 mm distal to the nerve-transected site were quantitatively examined at 100 days after the operation. The frequency distribution of myelinated fiber diameters showed that exogenous rhGAL-1/Ox increased the number and diameter of regenerating myelinated fibers; the number of medium-sized (6-11 microm in diameter) fibers increased significantly (P<0.05). These results indicate that oxidized galectin-1 promotes the restoration of nerve function after peripheral nerve injury. Thus, rhGAL-1/Ox may be a factor for functional restoration of injured peripheral nerves.

Animals↗
PubMed2005

Wheel-running modestly promotes functional recovery after a unilateral cortical lesion in rats.

BACKGROUND: We aimed to determine whether early or delayed wheel-running (W) after a cortical lesion in rats influences functional recovery and protein expression involving synaptic plasticity. METHODS: 57 rats were arranged in 4 groups: (1) Sham, (2) NMDA, (3) W-24 h or (4) W-72 h (W-24 h and W-72 h means wheel-running for 14 days starting day 1 or day 3 after NMDA lesion). NMDA produced a standardized lesion in the unilateral sensorimotor cortex and detectable behavioral deficits. Synaptogenesis was measured by immunohistochemistry. RESULTS: Wheel-running starting after 24 h had no detectable effect, but it significantly speeded functional recovery when delayed to after 72 h. These results were in accordance with a marker linked to synaptogenesis. CONCLUSION: Wheel-running starting 3 days, but not 1 day, after an NMDA lesion is associated with improved functional recovery.

Animals↗
PubMed2001

Two evoked responses with different recovery functions in the primary somatosensory cortex in humans.

OBJECTIVES: We investigated the recovery function of somatosensory evoked magnetic cortical fields (SEFs) to confirm the temporal aspects of the somatosensory process in humans. METHODS: SEFs were recorded following median nerve electrical stimulation in 6 healthy subjects. Double stimulation, with interstimulus intervals (ISIs) from 3 to 100 ms, was applied, and the SEF components for the second stimulation were analyzed. In a supplementary experiment, responses to single stimulations of various intensities from the sensory threshold to the motor threshold were studied. RESULTS: The first SEF component (1M) diminished when the ISI was less than 10 ms, while the second component (2M) remained even when the ISI was 3 ms. The two components showed a very similar attenuation with decrease of stimulus intensity. There was no significant difference in dipole location between 1M and 2M in the primary somatosensory cortex (SI). CONCLUSIONS: The results suggested that at least two independent pathways with different recovery functions exist in a similar area in the SI.

Adult↗
PubMed1993

Nitroglycerin improves functional recovery of neonatal lamb hearts after 2 hours of cold ischemia.

BACKGROUND: Vascular events during initial reperfusion after a period of hypothermic cardioplegic ischemia may play an important role in the recovery of mechanical function. Prior studies have shown (1) that dysfunction of the postischemic myocardium after normothermic ischemia can be ameliorated by vasodilation and (2) that endothelial dysfunction in the coronary bed and mechanical dysfunction were correlated after hypothermic ischemia. The present study was undertaken to further explore the relation between vascular events during reperfusion and the recovery of mechanical function after hypothermic ischemia by the infusion of the endothelium-independent vasodilator nitroglycerin during reperfusion. METHODS AND RESULTS: We assessed the effect of an infusion of nitroglycerin on the recovery of isolated blood-perfused neonatal lamb hearts arrested for 2 hours with 15 degrees C K+ cardioplegic solution, comparing 8 hearts receiving a nitroglycerin infusion with 9 control hearts. After 30 minutes of reperfusion, nitroglycerin-infused hearts compared with control hearts had better percent recovery of maximum left ventricular developed pressure (83.5 +/- 8.1% vs 73.6 +/- 8.9%, mean +/- SD), left ventricular dP/dt (77.2 +/- 7.7% vs 67.4 +/- 10.3%), coronary blood flow (141.2 +/- 30.6% vs 84.4 +/- 10.4%), and myocardial oxygen consumption (100.7 +/- 51.3% vs 71.2 +/- 18.6%), (all except myocardial oxygen consumption with P < .05). In each heart, we also tested the coronary vascular resistance response to 10(-6) mol/L acetylcholine infusion to assess endothelial function. The recovery of the coronary vascular resistance response to acetylcholine was reduced after reperfusion in both groups compared with the preischemic response to acetylcholine (nitroglycerin, 14.9 +/- 53.8%; control, 13.4 +/- 38.3%). CONCLUSIONS: These results suggest that the effects of hypothermia and reperfusion on recovery of mechanical function after hypothermic ischemia can be offset by an infusion of nitroglycerin. Vasospasm secondary to endothelial dysfunction may play an important role in cardiac recovery after hypothermic ischemia.

Animals↗
PubMed2001

Influence of the emotional response to surgery on functional recovery during 6 months after hip arthroplasty.

We examined whether the emotional response to hip arthroplasty predicted functional recovery after controlling for preoperative function and surgical trauma. Mood and fatigue were measured in 102 consecutive patients preoperatively and 3 days postoperatively. Time of achievement of functional milestones indicated recovery in hospital, and functional status was measured preoperatively and 1 and 6 months postoperatively. Circulating C-reactive protein and interleukin-6 levels indicated trauma. Recovery in hospital was slower in patients with greater trauma. Recovery at follow-up was slower in patients with poorer preoperative function and with greater anxiety and fatigue, but the apparent influence of anxiety was explained by its association with preoperative function and fatigue. Whereas short-term recovery is predicted by surgical trauma, long-term recovery is predicted by preexisting function and the emotional response to surgery. However, the influence of the emotional response is small and the important aspect of emotion is fatigue rather than anxiety.

Aged↗
PubMed1999

Auditory brainstem response forward-masking recovery functions in older humans with normal hearing.

We investigated the auditory brainstem response (ABR) recovery from forward masking using toneburst maskers and probes. Two subject groups matched for hearing thresholds were evaluated: normal-hearing young adults (21-40 years) and older subjects (63-77 years) with normal audiometric thresholds. Stimuli consisted of 1, 4 and 8 kHz tonebursts, with 2-4 cycle rise/fall time and no plateau. Forward maskers were tonebursts of the same frequency, with a 5 ms rise/fall time and a 20 ms plateau time. Probes were presented at 40 dB above threshold, and the forward masker was adjusted to a level that just eliminated the ABR to the 40 dB sensation level toneburst when the probe onset occurred at masker offset. Forward-masker intervals varied from 2 to 64 ms. ABR wave V latencies were similar for the young and old age groups regardless of toneburst frequency. Under forward-masking conditions, wave V latency was prolonged for the shorter intervals, and recovered to baseline latency by 64 ms. The forward-masker recovery functions were nearly identical for the two age groups for the 1 kHz toneburst. In contrast, there were clear differences in the recovery functions for the two age groups for the 4 and 8 kHz tonebursts. Specifically, the mean latency shift was greater for the aged group for forward-masker intervals of 16 ms or less. The two age groups showed identical latency shifts for longer forward-masker intervals. These data demonstrate prolonged recovery from forward masking in older human subjects. As these subjects had audiometric thresholds within normal limits, one plausible interpretation of this finding is that the prolonged recovery time is a manifestation of an aging effect on the central auditory nervous system rather than the periphery.

Acoustic Stimulation↗
PubMedDate not supplied

The effect of octreotide on morphological hepatic regeneration and hepatic functional recovery after a two-thirds hepatectomy in rats.

BACKGROUND/AIMS: The aim of this study was to clarify the effect of octreotide on either morphological hepatic regeneration or hepatic function after a two-thirds hepatectomy in rats. METHODOLOGY: The rats were separated into two groups as follows: group 1 received 100 microg of octreotide acetate subcutaneously every 6 hours from 24 hours before hepatic resection until sacrifice; group 2 received 0.9% saline solution instead of octreotide as a control. Morphological hepatic regeneration, protein synthesis and mitochondrial function were all studied. RESULTS: The regenerative rate in liver volume and the BrdU labeling index in group 1 were significantly lower than those in group 2. The levels of glutamic acid dehydrogenase were significantly lower in group 1 than those in group 2 at 24 (64.2+/-14.6 and 77.8+/-8.3 IU/l, respectively), 36 (46.1+/-14.4 and 60.6+/-5.9 IU/l, respectively) and 48 hours (39.7+/-13.7 and 51.0+/-11.8 IU/l, respectively) after hepatectomy. At 24 hours after hepatectomy, the levels of arterial ketone body ratio was higher in group 1 than in group 2 (0.67+/-0.05 and 0.51+/-0.07, respectively), and the energy charge of the liver was also higher in group 1 than in group 2 (0.662+/-0.031 and 0.605+/-0.053, respectively). CONCLUSIONS: Our results suggest that morphological hepatic regeneration is not necessarily synchronized with hepatic functional recovery. In addition, hepatic functional recovery was preserved by keeping the energy metabolism in hepatocytes, even when the use of octreotide suppressed morphological hepatic regeneration.

Animals↗
PubMed2006

[Controlled reperfusion improves the metabolic and functional recovery of the isolated heart in rats after total ischemia].

Metabolic and functional effects of a hypocalcium reperfusion solution (RS) with low oxygen content containing d-glucose, trisamine, d-mannitol and I-aspartic acid have been studied in isolated rat hearts. The hearts were initially perfused for 20 min with the Krebs solution under constant left atrial filling pressure of 15 mm Hg and aortic perfusion pressure of 60 mm Hg. Then they were subjected to 30-min total normothermic ischemia followed by 30-min of reperfusion. The Krebs solution (control, n=16) or RS (n=11) were infused in retrograde mode with a rate of 4 ml/min during first 5 min of reperfusion. After that the hearts of both groups were reperfused in antegrade mode with the Krebs solution for 25 min under initial conditions. Short-term infusion of RS markedly improved postischemic functional recovery of cardiac function. After 30-min reperfusion coronary flow, an index of contractile function intensity, expressed as the left ventricle developed pressure-heart rate product, and cardiac work, calculated as the minute volume-aortic perfusion pressure product, recovered up to 92+/-1%, 77+/-1% and 61+/-1% of baseline values, respectively. In the control group the same indices were significantly lower and were 74+/-3%, 48+/-5% and 33+/-2%, respectively (p<0.001). At the end of reperfusion hearts treated with RS compared with the control hearts showed higher myocardial levels of ATP, phosphocreatine (PCr) and total creatine (SCr). These metabolic findings indicate better recovery of energy state and lesser sarcolemmal damage of postischemic cardiomyocytes after RS infusion. Thus, optimization of administration mode and composition of reperfusion solutions is a promising tool to attenuate functional and metabolic disturbances of the postischemic heart.

Animals↗