title: Brain death impairs coronary endothelial function.
abstract: BACKGROUND
  To characterize the impact of brain death (BD) on endothelial dysfunction after cardiac transplantation we investigated coronary circulation and vasomotor function in a canine model.
  
  
  METHODS
  Left ventricular pressure-volume data (conductance catheter) and coronary blood flow (CBF) were monitored continuously. Endothelium-dependent vasodilatation after acetylcholine and endothelium-independent vasodilation after sodium nitroprusside were assessed before and 3 hr after BD induction (inflation of a subdural balloon).
  
  
  RESULTS
  BD led to an initial hyperdynamic reaction with significant (P<0.05) increase of CBF. After 3 hr, CBF decreased significantly (P<0.05). Although before BD, application of acetylcholine led to a monophasic vasodilatative response, after BD a short mild vasodilatation was followed by a longer vasoconstriction. Endothelium-independent vasodilatation remained unchanged.
  
  
  CONCLUSIONS
  BD affects coronary circulation by two means: (1) impairment of CBF to decrease in parallel in afterload with consecutive hemodynamic deterioration and (2) severe endothelial dysfunction that may be a contributing factor to posttransplant outcome.
authors.affiliation: Department of Cardiac Surgery, University of Heidelberg, Im Neueneheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Gabor
authors.initials: G
authors.lastname: Szabo
authors.forename: Volker
authors.initials: V
authors.lastname: Buhmann
authors.forename: Susanne
authors.initials: S
authors.lastname: Bahrle
authors.forename: Christian F
authors.initials: CF
authors.lastname: Vahl
authors.forename: Siegfried
authors.initials: S
authors.lastname: Hagl
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000818:Animals; D001926:Brain Death / Q000503:physiopathology*; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D003331:Coronary Vessels / Q000503:physiopathology*; D004285:Dogs; D004730:Endothelium, Vascular / Q000503:physiopathology*; D016027:Heart Transplantation; D006439:Hemodynamics / Q000502:physiology; D009599:Nitroprusside / Q000494:pharmacology; D011183:Postoperative Complications / Q000503:physiopathology; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D009599:Nitroprusside; D000109:Acetylcholine