Effect of a novel thromboxane A2 inhibitor on right ventricular-arterial coupling in endotoxic shock

Bernard Lambermont, Philippe Kolh, Alexandre Ghuysen, Patrick Segers, Jean-Michel Dogné, Vincent Tchana-Sato, Philippe Morimont, Patricia Benoit, Paul Gérard, Bernard Masereel, Vincent D'Orio

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Résumé

We investigated the effects of a dual thromboxane (TX)A2 synthase inhibitor and TXA2 receptor antagonist (BM-573) on right ventricular-arterial coupling in a porcine model of endotoxic shock. Thirty minutes before the onset of 0.5 mg/kg endotoxin infusion, six pigs (Endo group) received an infusion with a placebo solution, and six other pigs (Anta group) with BM-573. Right ventricular pressure-volume loops were obtained by the conductance catheter technique. The slope (Ees) of the end-systolic pressure-volume relationship and its volume intercept at 25 mmHg were calculated as measures of right ventricular systolic function. RV afterload was quantified by pulmonary arterial elastance (Ea), and Ees/Ea ratio represented right ventricular-arterial coupling. Mechanical efficiency was defined as the ratio of stroke work and pressure-volume area. In this model of endotoxic shock, BM-573 blunted the early phase of pulmonary hypertension, improved arterial oxygenation, and prevented a decrease in right ventricular myocardial efficiency and right ventricular dilatation. However, the drug could not prevent the loss of homeometric regulation and alterations in right ventricular-arterial coupling. In conclusion, dual TXA2 synthase inhibitor and receptor antagonists such as BM-573 have potential therapeutic applications, improving right ventricular efficiency and arterial oxygenation in endotoxic shock.
langue originaleAnglais
Pages (de - à)45-51
Nombre de pages7
journalShock (Augusta, Ga.)
Volume21
Numéro de publication1
Les DOIs
Etat de la publicationPublié - janv. 2004

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    Lambermont, B., Kolh, P., Ghuysen, A., Segers, P., Dogné, J-M., Tchana-Sato, V., Morimont, P., Benoit, P., Gérard, P., Masereel, B., & D'Orio, V. (2004). Effect of a novel thromboxane A2 inhibitor on right ventricular-arterial coupling in endotoxic shock. Shock (Augusta, Ga.), 21(1), 45-51. https://doi.org/10.1097/01.shk.0000095935.86703.ca