Brain death provokes very acute alteration in myocardial morphology detected by echocardiography: preventive effect of beta-blockers

作者：Ferrera Rene^*; Hadour Guylaine; Tamion Fabienne; Henry Jean Paul; Mulder Paul; Richard Vincent; Thuillez Christian; Ovize Michel; Derumeaux Genevieve

来源：Transplant International, 2011, 24(3): 300-306.

DOI：10.1111/j.1432-2277.2010.01184.x

• brain death
• echocardiography
• heart injury
• beta-blockade

P>Our objective was to evaluate immediate acute changes in myocardial function during the autonomic storm of brain death (BD). Wistar rats were divided into four groups (n = 8/group): controls without any treatment, beta-blocker (Esmolol (R), 10 mg/kg), calcium channel blocker (Diltiazem (R), 10 mg/kg), or alpha-blocker (Prazosin (R), 0.3 mg/kg). Treatments were administered intravenously 5 min before BD induction. Echocardiography (ATL-5000, 8 MHz) was performed to measure left ventricular (LV) dimensions and fractional shortening at baseline, during BD induction and 5 min and 15 min after BD. In controls, BD was immediately associated with an increase in wall thickness and a decrease in LV cavity dimension. This myocardial wall hypertrophy was completely prevented by beta-blockers, but not with calcium- and alpha-blockers. Extensive myocardial interstitial edema was found in all groups, except in the beta-blocker group. Myocardial wall hypertrophy was also prevented during a longer follow-up of 180 min after BD in beta-blocker group as opposed to controls. In conclusion, BD is associated with an immediate and severe myocardial damage related to an important interstitial edema which is prevented by beta-blockers.

• 出版日期2011-3