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The Annals of Thoracic Surgery, Vol 45, 50-55, Copyright © 1988 by The Society of Thoracic Surgeons
D Novitzky, PA Human and DK Cooper
A significant reduction (p less than 0.0001) in plasma-free
triiodothyronine (T3), which is known to have an inotropic effect, has been
documented in patients undergoing open-heart procedures. To investigate the
effect of this observation, 22 pigs underwent 2 hours (Group 1, r = 10) or
3 hours (Group 2, r = 12) of myocardial ischemia during cardiopulmonary
bypass (CPB) at 26 degrees C; the myocardium was protected by cardioplegic
solution and cold saline solution at 30- minute intervals. After the pig
was rewarmed to 37 degrees C, CPB was discontinued, and measurements of
hemodynamic function were made 10 and 70 minutes later. Half of the pigs
(Subgroup B) received 6 micrograms of T3 intravenously immediately after
removal of the aortic cross- clamp; the remainder (Subgroup A) received no
T3. After 2 hours of ischemia, untreated pigs showed significantly reduced
myocardial function 10 minutes after discontinuation of CPB. By 70 minutes
after the end of CPB, 2 of 5 untreated pigs (Subgroup A) had died of low
cardiac output, but all 5 treated pigs (Subgroup B) survived. After 3 hours
of ischemia, both groups showed some reduced function at 10 minutes, though
the reduction was more marked in untreated animals. By 70 minutes, 4 of 6
untreated pigs had died of myocardial failure and all treated pigs remained
alive (p less than 0.03). Surviving pigs in both groups still demonstrated
some reduced function compared with values obtained before CPB. When all
pigs are considered together, overall survival of those that did not
receive T3 was significantly less than those that did (p less than
0.006).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Inotropic effect of triiodothyronine following myocardial ischemia and cardiopulmonary bypass: an experimental study in pigs
Department of Cardiothoracic Surgery, University of Cape Town Medical School, South Africa.
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