Endothelin-1 blockade corrects mesenteric hypoperfusion in a porcine low cardiac output model

Abstract

Endothelin-1 blockade in acute cardiac failure improves mesenteric, but not renal, perfusion, illustrating the regional importance of endothelin-1-induced vasoconstriction. Importantly, endothelin-1 blockade restored mucosal blood flow and oxygenation, which might be particularly interesting considering the implications for maintenance of mucosal barrier integrity in low output states.

Dopamine under α1-blockade, but not dopamine alone or fenoldopam, increases depressed gastric mucosal oxygenation*

“…This discrepancy parallels the renal effects of dopamine, which proved to be effective under physiologic conditions but failed to be renoprotective under compromised circulatory conditions (11). We suggest that the vasodilatory DA 1 -receptor pathway fine-tunes splanchnic perfusion under physiologic conditions, such as during feeding (5), but that it is overridden under compromised cardiocirculatory conditions, that is, when potent splanchnic vasoconstrictors are released, such as endothelin (60), angiotensin (61), or vasopressin (50).…”

Diagnosis and management of splanchnic ischemia

“…The main vasoconstricting substances are the catecholamines and endothelin, especially endothelin-1 [20,21] . The main splanchnic vasodilators are nitric oxide (NO) and prostaglandins.…”

Splanchnic Blood Flow in Low-Flow States

“…In experimental acute cardiac failure, endothelin-1 blockade improved mesenteric but not renal perfusion (107). Endothelin-1 blockade also restored mucosal blood flow and oxygenation.…”