Clenbuterol-Supported Dynamic Training of Skeletal Muscle Ventricles Against Systemic Load

Guldner, Norbert W.; Klapproth, Peter; Großherr, M.; Schumacher, Matthias; Rumpel, Elisabeth; Noel, R; Sievers, Hans‐H.

doi:10.1161/01.cir.101.18.2213

Cited by 25 publications

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“…On the opposite side of the muscle, an electrode 60 mm long (Medtronic SP5591-500-60-NMS) was placed subfascially. 13 For the synchronization of the muscle contraction (BMH) with the action of the heart, a cardiac screw-in electrode (model 4951, Medtronic) was inserted into the apex of the left heart ( Figure 1). …”

Section: Myostimulator and Electrodesmentioning

confidence: 99%

“…5,13,17 During the first 3 weeks, the muscular wrap was stimulated by a myostimulator that was not synchronizable with the heart (Itrel II, Medtronic model 7424), delivering initially 1 contraction per 3 minutes up to 3 muscle contractions per minute after 3 weeks of training ( Table 1). The unsynchronized Itrel II was used because no available ECG-triggered myostimulator could deliver these low beat frequencies.…”

Section: Stimulation Protocol and Medicationmentioning

confidence: 99%

“…5,13,17 In contrast to stimulation protocols of other blood pumps, it starts during the first (only) operation with bursts with prolonged time intervals followed by an increasing number of bursts per minute, including an increasing number of pulses per burst.…”

Section: Stimulation Protocolmentioning

confidence: 99%

“…SMVs in goats built around a training device with a chamber volume of 150 mL, pumping against a load of 60 to 70 mm Hg without any drug administration, however, were not successful. 13 Thus, drugs were tested to generate more muscular power.…”

mentioning

confidence: 99%

“…14 By use of an elastic device, dynamically trained intrathoracic SMVs without vascular delay and supported by clenbuterol were able to contract against a constant load of 60 to 70 mm Hg immediately after construction, and they pumped Ͼ1 L/min continuously after several months of training. 13 Relevant side effects of clenbuterol are not in question, because it has been in clinical use for the treatment of chronic pulmonary obstruction for years in a similar dosage. Furthermore, the well-known cardiac arrhythmogenic effects of ␤ 2 -receptor stimulators in general should be negligible for clenbuterol.…”

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confidence: 99%

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Biomechanical Hearts

et al. 2001

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Background-As shown previously in goats, clenbuterol increased the power of electrically conditioned skeletal muscle ventricles (SMVs) of clinically relevant size (150 mL), which were constructed around a mock system. They pumped against a pressure of 60 to 70 mm Hg immediately during surgery and up to several months after, finally at Ͼ1 L/min. SMVs without clenbuterol administration failed. Thus, we expected that clenbuterol-supported SMVs might become integrated into the circulation by a 1-step operation instead of the 2-step procedure required up to now. Methods and Results-In adult Boer goats (nϭ5), latissimus dorsi muscle was wrapped around a polyurethane chamber of 150 mL that was connected to the descending aorta. This muscular flow-through pumping chamber containing a stabilizing inner layer (called a biomechanical heart [BMH]) was formed and immediately made to work against a systemic load with the support of clenbuterol (5ϫ150 g/wk). During surgery, the mean stroke volume of BMHs was 53.8Ϯ22.4 mL. One month after surgery, in peripheral arterial pressure, the mean diastolic (P MD ) and minimal diastolic (P min ) pressures of BMH-supported heart cycles differed significantly from unsupported ones (P MD ϭϩ2.9Ϯ1.1 mm Hg [PϽ0.04], P min ϭϪ2.4Ϯ0.9 mm Hg [PϽ0.04]). After BMH-supported heart contractions, the subsequent maximal rate of pressure generation, dP/dt max , increased by 20.5Ϯ8.1% (PϽ0.02). One BMH, catheterized 132 days after surgery, shifted a volume of 34.

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Section: Myostimulator and Electrodesmentioning

confidence: 99%

Section: Stimulation Protocol and Medicationmentioning

confidence: 99%

Section: Stimulation Protocolmentioning

confidence: 99%

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Adaptive change in electrically stimulated muscle: A framework for the design of clinical protocols

Salmons

2009

Muscle and Nerve

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Adult mammalian skeletal muscles have a remarkable capacity for adapting to increased use. Although this behavior is familiar from the changes brought about by endurance exercise, it is seen to a much greater extent in the response to long-term neuromuscular stimulation. The associated phenomena include a markedly increased resistance to fatigue, and this is the key to several clinical applications. However, a more rational basis is needed for designing regimes of stimulation that are conducive to an optimal outcome. In this review I examine relevant factors, such as the amount, frequency, and duty cycle of stimulation, the influence of force generation, and the animal model. From these considerations a framework emerges for the design of protocols that yield an overall functional profile appropriate to the application. Three contrasting examples illustrate the issues that need to be addressed clinically.

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The adaptive response of skeletal muscle: What is the evidence?

Salmons

2017

Muscle and Nerve

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Adult skeletal muscle is capable of adapting its properties in response to changing functional demands. This now sounds like a statement of the obvious, and many people assume it has always been this way. A mere 40 years ago, however, the picture was entirely different. In this Review and personal memoir, I outline the scientific context in which the theory was generated, the objections to it from entrenched opinion, and the way those objections were progressively met. The material should be of some historical interest, but, more importantly, it collects together the full range of evidence on which the current paradigm is based. Muscle Nerve 57: 531-541, 2018.

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Clenbuterol-Supported Dynamic Training of Skeletal Muscle Ventricles Against Systemic Load

Abstract: This clenbuterol-supported dynamic training provides powerful SMVs that may have important clinical implications for the treatment of end-stage heart failure by muscular blood pumps.

Cited by 25 publications

References 20 publications

Biomechanical Hearts

Biomechanical Hearts

Adaptive change in electrically stimulated muscle: A framework for the design of clinical protocols

The adaptive response of skeletal muscle: What is the evidence?

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