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Effects of gadolinium on regionally stunned myocardium: temporal considerations. J Surg Res 2007 May 15;139(2):286-91 PMID: 17270216

Pubmed ID

17270216

Abstract

OBJECTIVES: The lanthanide cation, gadolinium (Gd(3+)), accelerates recovery of stunned myocardium when given prior to ischemia. This study sought to determine whether giving Gd(3+) during ischemia or during reperfusion also ameliorates stunning, as these temporal relationships could help determine the clinical utility of this novel agent.

METHODS: Regional myocardial stunning was induced in anesthetized dogs by coronary occlusion for 15 min followed by reperfusion for 3 h. Gd(3+) (500 micromol) was given intravenously in three treatment groups: [1] preischemia; [2] during ischemia; [3] after reperfusion. No Gd(3+) was given to controls (Group 4). Measures of global and regional myocardial function were assessed serially.

RESULTS: Treatment with Gd(3+) prior to ischemia (Group 1) had no effects on hemodynamics or regional contraction. Coronary occlusion resulted in diastolic lengthening and paradoxical systolic bulging equally in all groups. After 3 h of reperfusion, regional systolic shortening (%) in the stunned segment was greater in Groups 1 (10.9 +/- 3.4; P = 0.02) and 2 (6.6 +/- 1.3; P = 0.047) compared with controls (-0.6 +/- 0.03). Recovery of systolic function (% of baseline shortening) after 3 h of reperfusion was similarly improved in Groups 1 (56.1 +/- 16.8; P = 0.02) and 2 (43.3 +/- 8.1; P = 0.04) compared with controls (-11.5 +/- 4.7).

CONCLUSIONS: Gadolinium has no inherent inotropic effects but enhances recovery of stunned myocardium. This effect appears maximal if Gd(3+) is given prior to ischemia, indicating potential utility in elective cardiac surgical procedures or percutaneous coronary interventions. Gadolinium also enhances recovery if given during ischemia but prior to reperfusion, and may thus be useful in acute coronary syndromes as well.

Author List

Nicolosi AC, Kwok CS, Logan B

Author

Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-34047263271   4 Citations

MESH terms used to index this publication - Major topics in bold

Animals
Dogs
Gadolinium
Heart
Myocardial Contraction
Myocardial Ischemia
Myocardial Reperfusion Injury
Myocardial Stunning
Recovery of Function
Systole
Time Factors
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70