Endogenous opioids do not mediate HCl-induced myocardial dysfunction

Pediatr Res. 1988 Jun;23(6):643-6. doi: 10.1203/00006450-198806000-00023.

Abstract

We evaluated the hypothesis that increased endogenous opioid activity mediates part or all of the left ventricular contractile and pump dysfunction previously demonstrated in HCl-induced metabolic acidemia. Eighteen Western newborn lambs were catheterized and instrumented; pacing wires were sutured to the right atrial appendage; a catheter mounted micromanometer pressure transducer was inserted into the left ventricle; and a 2.5 F thermistor was inserted into the distal abdominal aorta. The lambs were studied 3 days after surgery. Metabolic acidemia was produced with an infusion of 0.5 N HCl into the inferior vena cava. Inhibition of endogenous opioids was achieved with a bolus of 2 mg/kg of intravenous naloxone, which was demonstrated to inhibit morphine sulfate-induced myocardial dysfunction. The effects of opioid inhibition were contrasted with our previously published results after restoration of a normal arterial pH with intravenous sodium bicarbonate. In agreement with our previous study, we found that reducing the arterial pH from 7.41 +/- 0.01 to 6.97 +/- 0.04 was associated with a 45% reduction in cardiac output which resulted from a 50% reduction in stroke volume. These changes in turn were mediated by a 35% reduction in the maximal first derivative of left ventricular pressure and/or a 63% increase in systemic vascular resistance which we used to estimate contractility and afterload, respectively. Left ventricular end diastolic pressure increased during acidemia. Although opioid inhibition produced a consistent increase in the maximal first derivative of left ventricular pressure, this increase was relatively small and was not associated with a significant change in cardiac output, stroke volume, or systemic vascular resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acidosis / chemically induced
  • Acidosis / physiopathology*
  • Animals
  • Animals, Newborn
  • Asphyxia Neonatorum / complications
  • Asphyxia Neonatorum / physiopathology
  • Bradycardia / etiology*
  • Bradycardia / physiopathology
  • Cardiac Output, Low / etiology*
  • Cardiac Output, Low / physiopathology
  • Disease Models, Animal / physiopathology*
  • Endorphins / physiology*
  • Heart Ventricles
  • Humans
  • Hydrochloric Acid / toxicity
  • Infant, Newborn
  • Naloxone / pharmacology
  • Sheep
  • Stroke Volume

Substances

  • Endorphins
  • Naloxone
  • Hydrochloric Acid