title: Brain death provokes very acute alteration in myocardial morphology detected by echocardiography: preventive effect of beta-blockers.
abstract: Our objective was to evaluate immediate acute changes in myocardial function during the autonomic storm of brain death (BD). Wistar rats were divided into four groups (n = 8/group): controls without any treatment, β-blocker (Esmolol®, 10 mg/kg), calcium channel blocker (Diltiazem®, 10 mg/kg), or alpha-blocker (Prazosin®, 0.3 mg/kg). Treatments were administered intravenously 5 min before BD induction. Echocardiography (ATL-5000, 8 MHz) was performed to measure left ventricular (LV) dimensions and fractional shortening at baseline, during BD induction and 5 min and 15 min after BD. In controls, BD was immediately associated with an increase in wall thickness and a decrease in LV cavity dimension. This myocardial wall hypertrophy was completely prevented by β-blockers, but not with calcium- and alpha-blockers. Extensive myocardial interstitial edema was found in all groups, except in the β-blocker group. Myocardial wall hypertrophy was also prevented during a longer follow-up of 180 min after BD in β-blocker group as opposed to controls. In conclusion, BD is associated with an immediate and severe myocardial damage related to an important interstitial edema which is prevented by β-blockers.
authors.affiliation: Inserm, U886, Université de Lyon, Université Lyon 1, Lyon, France. rene.ferrera@recherche.univ-lyon1.fr
authors.forename: René
authors.initials: R
authors.lastname: Ferrera
authors.forename: Guylaine
authors.initials: G
authors.lastname: Hadour
authors.forename: Fabienne
authors.initials: F
authors.lastname: Tamion
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Henry
authors.forename: Paul
authors.initials: P
authors.lastname: Mulder
authors.forename: Vincent
authors.initials: V
authors.lastname: Richard
authors.forename: Christian
authors.initials: C
authors.lastname: Thuillez
authors.forename: Michel
authors.initials: M
authors.lastname: Ovize
authors.forename: Geneviève
authors.initials: G
authors.lastname: Derumeaux
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D001926:Brain Death / Q000473:pathology* / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004110:Diltiazem / Q000627:therapeutic use; D004452:Echocardiography; D004487:Edema / Q000209:etiology / Q000517:prevention & control; D006339:Heart Rate / Q000187:drug effects; D008297:Male; D009206:Myocardium / Q000473:pathology*; D011224:Prazosin / Q000627:therapeutic use; D011412:Propanolamines / Q000627:therapeutic use*; D051381:Rats; D017208:Rats, Wistar
chemical_list: D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D011412:Propanolamines; D004110:Diltiazem; C036604:esmolol; D011224:Prazosin