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Cardiovascular function following acute volume overload for hydrodynamic gene delivery to the liver

Abstract

Hydrodynamic gene delivery to the liver is a valuable experimental tool and an attractive option for nonviral gene therapy of liver disease. However, little attention has been paid to the major obstacle to clinical application: acute volume overload of the cardiovascular system. We delivered volumes of DNA solution (pGL3 plasmid) corresponding to 1, 2, 4, 6 and 8% of the body weight at 100 ml/min to the inferior vena cava (IVC) of DA strain rats. Central venous pressure (CVP), arterial pressure, pulse and electrocardiogram (ECG) were continuously recorded for subsequent analysis. Each volume produced a characteristic response, but all (including the 1% volume) caused severe falls in blood pressure and pulse within 1–2 s of the infusion, with ectopic beats and widening of the QRS complex in the ECG. The response to volumes of 4% and higher suggested that the liver acted as a volume sink, mitigating the immediate effects of volume overload. The 6 and 8% volumes caused profound and protracted falls in blood pressure and pulse, with a multitude of severe electrical abnormalities in the heart, including electromechanical dissociation. Vagal blockade with atropine, and the use of Ringer's solution to prevent electrolyte disturbances, did not ameliorate this picture.

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Acknowledgements

We thank Mr Robert Jones (Linton Instrumentation, Norfolk, UK) for his advice on the use of the AcqKnowledge software. This work was supported by the UK Department of Health, the Medical Research Council of the UK and the Welton Foundation.

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Correspondence to J W Fabre.

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Supplementary Information accompanies the paper on Gene Therapy website (http://www.nature.com/gt)

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Sawyer, G., Dong, X., Whitehorne, M. et al. Cardiovascular function following acute volume overload for hydrodynamic gene delivery to the liver. Gene Ther 14, 1208–1217 (2007). https://doi.org/10.1038/sj.gt.3302976

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