Document Detail


Postischemic [Ca2+] repletion improves cardiac performance without altering oxygen demands.
MedLine Citation:
PMID:  2369187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The positive inotropism expected with correction of postischemic hypocalcemia might be counterbalanced by potential aggravation of reperfusion injury, in particular by calcium overload. We evaluated the effect of normalizing blood calcium concentration ([Ca2+]) on postischemic left ventricular systolic and diastolic mechanics using oxygen consumption and indices derived from pressure-diameter relations. In 10 open-chest dogs on cardiopulmonary bypass, the hearts underwent 30 minutes of normothermic global ischemia followed by one hour of multidose hypothermic (4 degrees C), hypocalcemic (0.3 mmol/L) blood cardioplegia. After reperfusion, systemic [Ca2+] had decreased to 70% of control (p = 0.017). The left ventricular inotropic state was significantly depressed from baseline (control) values, but was restored to baseline levels by resumption of normocalcemia after one hour of reperfusion. Chamber stiffness increased by 308% (p = 0.006) after hypocalcemic reperfusion but decreased significantly after [Ca2+] correction. Recovery of left ventricular performance with [Ca2+] correction did not augment myocardial oxygen consumption from the postischemic uncorrected state (5.0 +/- 0.3 mL O2/min/100 g versus 5.3 +/- 0.3 mL O2/min/100 g). We conclude that normalizing [Ca2+] after blood cardioplegia improves postischemic left ventricular performance without adversely affecting compliance or oxygen consumption.
Authors:
H Yokoyama; J S Julian; J Vinten-Johansen; W E Johnston; T D Smith; D S McGee; A R Cordell
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  49     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1990 Jun 
Date Detail:
Created Date:  1990-08-13     Completed Date:  1990-08-13     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  894-902     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure / drug effects,  physiology
Calcium / blood*
Calcium Chloride / administration & dosage,  therapeutic use*
Cardiac Output / drug effects,  physiology
Coronary Circulation / drug effects,  physiology
Dogs
Heart / physiology*
Heart Arrest, Induced
Hypocalcemia / physiopathology
Myocardial Contraction / drug effects*,  physiology
Myocardial Reperfusion
Myocardium / metabolism*
Oxygen Consumption / drug effects*,  physiology
Stroke Volume / drug effects,  physiology
Grant Support
ID/Acronym/Agency:
HL36377/HL/NHLBI NIH HHS; HL40395/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
10043-52-4/Calcium Chloride; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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