Changes in Atrial Natriuretic Peptide Levels During Cardiac Bypass in the Fetal Goat

Zhou, Chunmei; Zhuang, Jian; Zhang, Xiaohua; Zhang, Jinfang

doi:10.1111/j.1525-1594.2008.00686.x

Cited by 11 publications

(12 citation statements)

References 21 publications

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“…Zhou et al . associated increased plasma TnI with depressed myocardial function in a fetal goat model 21. In support of these findings, the present study detected TnI degradation in the fetal heart by immunoblot of myocardial homogenates.…”

Section: Discussionsupporting

confidence: 87%

Myocardial function after fetal cardiac bypass in an ovine model

Duffy

Petrucci

Baker

et al. 2011

The Journal of Thoracic and Cardiovascular Surgery

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Objective Fetal cardiac surgery may improve the prognosis of certain complex congenital heart defects that have significant associated mortality and morbidity in utero or after birth. An important step in translating fetal cardiac surgery is identifying potential mechanisms leading to myocardial dysfunction following bypass. The hypothesis was that fetal cardiac bypass results in myocardial dysfunction, possibly due to perturbation of calcium cycling and contractile proteins. Methods Mid-term sheep fetuses (n=6) underwent 30 minutes of cardiac bypass and 120 minutes of monitoring after bypass. Sonomicrometry and pressure catheters inserted in left (LV) and right ventricles (RV) measured myocardial function. Cardiac contractile and calcium cycling proteins, along with calpain, were analyzed by immunoblot. Results Preload recruitable stroke work (slope of the regression line) was reduced at 120 min after bypass (RV – baseline vs. 120 min after bypass, 38.6±6.8 vs. 20.4±4.8 (P=.01); LV – 37±7.3 vs. 20.6±3.9 (P=.01). Tau (msec), a measure of diastolic relaxation, was elevated in both ventricles (RV – baseline vs. 120 min after bypass, 32.7±4.5 vs. 67.8±9.4 (P<.01); LV – 26.1±3.2 vs. 63.2±11.2 (P=.01). Cardiac output was lower and end-diastolic pressures were higher in the RV, but not the LV, after bypass compared with baseline. RV troponin I was degraded by elevated calpain activity and protein levels of sarco(endo)plasmic reticulum calcium ATPase (SERCA2a) were reduced in both ventricles. Conclusions Fetal cardiac bypass was associated with myocardial dysfunction and disruption of calcium cycling and contractile proteins. Minimizing myocardial dysfunction after cardiac bypass is important for successful fetal surgery to repair complex congenital heart defects.

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Section: Discussionsupporting

confidence: 87%

Myocardial function after fetal cardiac bypass in an ovine model

Duffy

Petrucci

Baker

et al. 2011

The Journal of Thoracic and Cardiovascular Surgery

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“…In the present study, the Tei index increased significantly in the ventricles post-arrest (P<0.05). Similarly, in a late third-trimester goat model, LV and RV myocardial dysfunction was observed (30), with an increased Tei index value 1 h after CPB. The separate evaluation of RV and LV dysfunction provides information on the sensitivity of each ventricle to hemodynamic alterations during bypass, which may then affect fetal blood composition (29).…”

Section: Discussionmentioning

confidence: 77%

“…This leads to difficulties in performing standard echocardiographic measurements of ventricular function in the ovine fetus, due to distorted ventricular geometry, preload and afterload (11). By contrast, the Tei index applies nongeometric assessment and overcomes such difficulties inherent to geometric assessment of LV and RV function (30). This suggests that it is a sensitive indicator of fetal ventricular dysfunction following cardioplegic arrest, particularly in the evaluation of ventricular dysfunction post-bypass.…”

Section: Discussionmentioning

confidence: 99%

Assessing the impact of total extracorporeal circulation on hemodynamics in an ovine fetal model

Xiao

Zhuang

Zhou

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to evaluate the impact of total extracorporeal circulation on hemodynamics and placental function in an ovine fetal model. Mid-term ovine fetuses (n=6) underwent extracorporeal circulation (30 min), cardioplegic arrest (20 min) and monitoring (120 min). The ascending aorta and umbilical cords of the fetuses were occluded during the bypass and an extracorporeal membrane oxygenator was used as the oxygen source. Biventricular intracardiac pressures, echocardiographic data, blood gas levels and placental function variables were recorded, and statistical analysis was performed using the repeated-measure analysis of variance test. The data indicated that fetal heart rate and blood pressure at 30, 60, 90 and 120 min following the bypass were stable relative to pre-arrest baseline (pre-bypass) values (P>0.05). However, end diastolic pressures in the ovine right ventricles post-bypass were significantly increased at 30, 60, 90 and 120 min relative to pre-bypass pressures (P<0.05). The pulsatility index also increased at 30 min post-bypass relative to the pre-bypass score (0.91±0.06 vs. 0.61±0.14; P=0.007). The mean resistivity index at all time points post-bypass was consistent with the pre-bypass score (P>0.05), while the mean Tei index values for the left and right ventricles post-bypass were significantly higher at all time points relative to pre-bypass values (P<0.05). The pre-bypass fetal blood pH, SaO 2 , base excess and lactate values were maintained during arrest (P>0.05). Fetal hemodynamics and placental function additionally remained stable for up to 2 h upon reperfusion following total extracorporeal circulation and cardioplegic arrest. Collectively these data suggest that the reproducible ovine fetal model may be useful in the evaluation of fetal cardiac surgery.

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“…43 More recently, it was shown that fetal bypass leads to cardiac injury, reflected in troponin elevation and increased plasma natriuretic peptides. 55 Calcium-handling properties of the fetal myocardium differ from the more mature state, and recent studies have started to define strategies for myocardial protection during fetal open heart surgery. 51,52 …”

Section: Fetal Cardiac Function and The Fetal Stress Responsementioning

confidence: 99%