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1 Michael E. DeBakey Institute for Comparative Cardiovascular Science, Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, 77843; and 2 Center for Microvascular and Lymphatic Studies, Department of Anesthesiology, The University of Texas Medical School, Houston, Texas 77030
Myocardial edema occurs in many pathological conditions. We
hypothesized that protein washdown at the myocardial microvascular exchange barrier would change the distribution of interstitial proteins
from large to small molecules and diminish the effect of washdown on
the colloid osmotic pressure (COP) of interstitial fluid and lymph.
Dogs were instrumented with coronary sinus balloon-tipped catheters and
myocardial lymphatic cannulas to manipulate myocardial lymph flow and
to collect lymph. Myocardial venous pressure was elevated by balloon
inflation to increase transmicrovascular fluid flux and myocardial
lymph flow. COP of lymph was measured directly and was also calculated
from protein concentration. Decreases occurred in both protein
concentration and COP of lymph. The proportion of lymph protein
accounted for by albumin increased significantly, whereas that
accounted for by
-lipoprotein decreased significantly. The change in
the calculated plasma-to-lymph COP gradient was significantly greater
than the change in the measured COP gradient. We conclude that the
change in the distribution of interstitial fluid protein species
decreases the effect of protein washdown on interstitial fluid COP and
limits its effectiveness as a defense mechanism against myocardial
edema formation.
interstitial heart disease; colloid osmotic pressure
This article has been cited by other articles:
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U. Mehlhorn, H. J. Geissler, G. A. Laine, and S. J. Allen Myocardial fluid balance Eur. J. Cardiothorac. Surg., December 1, 2001; 20(6): 1220 - 1230. [Abstract] [Full Text] [PDF] |
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