Comparative Cardiac Effects of Terlipressin, Vasopressin, and Norepinephrine on an Isolated Perfused Rabbit Heart
- 1 January 2005
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesiology
- Vol. 102 (1), 85-92
- https://doi.org/10.1097/00000542-200501000-00016
Abstract
Background Terlipressin, a synthetic analog of arginine-vasopressin (AVP), has been proposed as an effective vasopressive therapy in catecholamine-resistant vasodilatory shock. Although beneficial effects of terlipressin on systemic arterial pressure have been clearly demonstrated, its intrinsic effects on coronary circulation and myocardial performances remain unknown. Methods The authors compared the coronary and myocardial effects of terlipressin (1-100 nM, n = 10), AVP (10-1000 pM, n = 10), and norepinephrine (1-100 nM, n = 10) on an erythrocyte-perfused isolated rabbit heart. The cardiac effects of terlipressin were also assessed in erythrocyte-perfused hearts in which the myocardial oxygen delivery was maintained constant and buffer-perfused hearts. Finally, the cardiac effects of terlipressin and AVP were studied in hearts pretreated by [d(CH2)5Tyr(Me)]AVP (0.1 microM), a selective V1a receptor antagonist. Results Norepinephrine induced a biphasic coronary effect associated with a concentration-dependent increase in myocardial performances. AVP and terlipressin significantly decreased coronary blood flow and impaired myocardial performances from 30 pM and 30 nM, respectively (P < 0.05). The cardiac side-effects of terlipressin were confirmed in buffer-perfused hearts but the maintenance of a constant myocardial oxygen delivery constant abolished its effects on myocardial performances. The cardiac effects induced by terlipressin and AVP were nearly completely abolished on hearts pretreated by [d(CH2)5Tyr(Me)]AVP. Conclusions On isolated rabbit heart, terlipressin induced a coronary vasopressor effect and in turn myocardial depression only at supratherapeutic concentrations (> or =30 nM). Its effects are mainly mediated via V1a receptors. However, these potential negative side effects on the heart were less pronounced than were those of AVP.Keywords
This publication has 26 references indexed in Scilit:
- Arginine vasopressin compromises gut mucosal microcirculation in septic ratsCritical Care Medicine, 2004
- Ischemic skin lesions as a complication of continuous vasopressin infusion in catecholamine-resistant vasodilatory shock: Incidence and risk factors*Critical Care Medicine, 2003
- The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective AnalysisAnesthesia & Analgesia, 2001
- Treatment of Intraoperative Refractory Hypotension with Terlipressin in Patients Chronically Treated with an Antagonist of the Renin-Angiotensin SystemAnesthesia & Analgesia, 1999
- Time profile of the haemodynamic effects of terlipressin in portal hypertensionJournal of Hepatology, 1997
- Effects of Propofol and Thiopental on Coronary Blood Flow and Myocardial Performance in an Isolated Rabbit HeartAnesthesiology, 1994
- A controlled study of glypressin versus vasopressin in the control of bleeding from oesophageal varicesJournal of Gastroenterology and Hepatology, 1990
- Effects of an Intravenous Infusion of Noradrenaline on the Plasma Concentration of Free and Sulfoconjugated Catecholamines in Anesthetized DogsPharmacology, 1986
- CONVERSION OF TRIGLYCYLVASOPRESSIN TO LYSINE-VASOPRESSIN IN MANJournal of Endocrinology, 1980
- [1-(.beta.-mercapto-.beta.,.beta.-cyclopentamethylenepropionic acid),2-(O-methyl)tyrosine]arginine-vasopressin and [1-(.beta.-mercapto-.beta.,.beta.-cyclopentamethylenepropionic acid)]arginine-vasopressin, two highly potent antagonists of the vasopressor response to arginine-vasopressinJournal of Medicinal Chemistry, 1980