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1 A. C. Burton Vascular Biology Laboratory and 2 Cardiovascular Surgery, London Health Sciences Center, Victoria Campus, London, Ontario, Canada N6A 4G5
In this study we
sought to determine the effect of sepsis on two sequelae of prolonged
(24-h)
-agonist administration, myocardial hypertrophy and
catecholamine-induced cardiotoxicity. Sprague-Dawley rats were
randomized to cecal ligation and perforation (CLP) or sham study groups
and then further randomized to receive isoproterenol (2.4 mg · kg
1 · day
1 iv) or placebo
treatment. At 24 h, myocardial function was assessed by using the
Langendorff isolated-heart technique or the heart processed for plain
light microscopy. We found that 1)
sepsis reduced contractile function, indicated by a rightward shift in the Starling curve (ANOVA with repeated measures, sepsis effect, P < 0.002);
2) sepsis-induced myocardial
depression was reversed by isoproterenol treatment (isoproterenol
effect, P < 0.0001); 3) sepsis reduced, but did not
block, isoproterenol-induced myocardial hypertrophy (isoproterenol
effect, P < 0.0001);
4) sepsis did not protect the heart
from catecholamine-induced tissue injury; 5) the septic heart was protected
against the effects of ischemiareperfusion (decreased
postreperfusion resting tension, ANOVA with repeated measures,
P < 0.01), an effect attenuated by
isoproterenol treatment (P < 0.005);
and 6) sepsis reduced the incidence
of sustained asystole or ventricular fibrillation after
ischemia-reperfusion (P < 0.05), an effect also attenuated by isoproterenol treatment (P < 0.01). We conclude that, in
sepsis,
-agonists induce changes in myocardial weight and function
consistent with acute myocardial hypertrophy. These changes occur at
the expense of significant tissue injury and increased sensitivity to
ischemia-reperfusion-induced tissue injury.
infection; heart; circulation; peritonitis; ischemia-reperfusion
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