Renal circulation and cellular metabolism during left ventricular assisted circulation: comparison study of pulsatile and nonpulsatile assists.
We examined left ventricular assist during 6 h for an acute myocardial infarction model in pigs. The outflow cannula was placed in the ascending aorta and an inflow cannula in the left atrium. A pump (Pulsatile group: Zeon Medical and Nonpulsatile group: Nikkiso HPM-15) was connected to each cannula. Items measured were the regional blood flow of the cortex and the medulla in the kidney, renal arterial flow, arterial blood ketone body ratio (AKBR), lactate/pyruvic acid, BUN, creatinine and beta 2-microglobulin. After experimental study, the kidneys were removed, and a pathological study was performed. In the pulsatile assisted group, renal cortical blood flow increased but medulla blood flow decreased. On the other hand, in the nonpulsatile assisted group, both regional blood flows decreased. That means that in the pulsatile assisted group intrarenal redistribution improved, rather than in the nonpulsatile assisted group. The results of our study indicated that pulsatile assist produced superior circulation in the kidney, and the microcirculation on the cell level was superior as well in early treatment of acute left heart failure.
Sezai
A
A
Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Shiono
M
M
Orime
Y
Y
Nakata
K
K
Hata
M
M
Yamada
H
H
Iida
M
M
Kashiwazaki
S
S
Kinishita
J
J
Nemoto
M
M
Koujima
T
T
Sezai
Y
Y
Saitoh
T
T
D000818:Animals; D001794:Blood Pressure / Q000502:physiology*; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000652:urine; D004195:Disease Models, Animal; D004912:Erythrocytes / Q000166:cytology / Q000473:pathology; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000592:standards*; D007657:Ketone Bodies / Q000378:metabolism; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D007672:Kidney Cortex / Q000098:blood supply; D007678:Kidney Glomerulus / Q000473:pathology; D007679:Kidney Medulla / Q000098:blood supply; D007684:Kidney Tubules / Q000473:pathology; D019344:Lactic Acid / Q000652:urine; D008833:Microcirculation / Q000502:physiology; D011673:Pulsatile Flow / Q000502:physiology*; D019289:Pyruvic Acid / Q000652:urine; D012079:Renal Circulation / Q000502:physiology*; D012770:Shock, Cardiogenic / Q000503:physiopathology / Q000628:therapy; D013552:Swine; D016277:Ventricular Function, Left / Q000502:physiology; D001613:beta 2-Microglobulin / Q000378:metabolism
D007657:Ketone Bodies; D001613:beta 2-Microglobulin; D019344:Lactic Acid; D019289:Pyruvic Acid; D003404:Creatinine