title: Isolation of "myocardial depressant factor(s)" from the ultrafiltrate of heart failure patients with acute renal failure.
abstract: Cardiac function improvement seen with hemofiltration may be attributable to "cardiac depressant factor(s)" removal. The authors have attempted "factor" isolation. Initial 12 hr hemofiltrate was obtained from: 4 patients with acute congestive heart failure (cardiac index: 2.02 +/- 0.48) and acute renal failure (blood urea nitrogen [BUN] 97.7 +/- 32.7; serum creatinine [SCr] 6.2 +/- 3.4 mg%) (Group I); 8 patients with chronic congestive heart failure (CI: 2.69 +/- 1.3) and mild renal failure (BUN 48.8 +/- 31.4; SCr 3.5 +/- 2.4 mg%) (Group II); and 8 patients with end-stage renal disease and no congestive heart failure (Group III). Crude samples were passed through C18Sep-Pak, and eluted with methanol/water mixtures, and 50% methanol samples were fractionated by high pressure liquid chromatography. Inotropic response was studied by injecting samples (in Krebs-Hensleit buffer) into a Langendorff rat heart preparation. The effect of pH, acetate, salts, and adding propranolol on the inotropic response also was tested. Myocardial depression followed all vehicle and preparatory elements: 0.1 M HCl (-47%); 0.08 M acetic acid (-75%); Na acetate (-25%); 0.1 M NaHCO3 (-11%); Na citrate (-84%); and Na glutarate (-14%). Group I had biphasic responses, the positive inotropism accorded to catecholamines, whereas negative inotropism was equal in each patient (-40.3%). Group II had a biphasic response with negative (-15%) inotropism noted. Group III was weakly biphasic. The data indicate there was myocardial depressive activity, most pronounced in Groups I and II, after method interference was corrected.
authors.affiliation: Research Institute, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: P
authors.initials: P
authors.lastname: Blake
authors.forename: Y
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: M C
authors.initials: MC
authors.lastname: Khosla
authors.forename: F
authors.initials: F
authors.lastname: Fouad-Tarazi
authors.forename: N
authors.initials: N
authors.lastname: Sakura
authors.forename: E P
authors.initials: EP
authors.lastname: Paganini
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000150:complications / Q000628:therapy*; D000818:Animals; D002851:Chromatography, High Pressure Liquid; D006321:Heart / Q000187:drug effects; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000628:therapy*; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D066298:In Vitro Techniques; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D009200:Myocardial Contraction / Q000187:drug effects; D009201:Myocardial Depressant Factor / Q000302:isolation & purification* / Q000494:pharmacology; D051381:Rats
chemical_list: D009201:Myocardial Depressant Factor