Multi-dose crystalloid cardioplegia preserves intracellular sodium homeostasis in myocardium

Victor D. Schepkin, Isaac O. Choy, Thomas F. Budinger, J Nilas Young, William M. Decampli

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

The goal of this study was to assess the effect of multi-dose St Thomas' cardioplegia on intracellular sodium homeostasis in a rat heart model. A new magnetic resonance method was applied which enable us to detect intracellular Na changes without chemical shift reagents. Three groups of isolated rat hearts were subjected to 51 min of ischemia and 51 min of reperfusion at 37°C: Group 1 - three infusions of St Thomas cardioplegia every 17 min for 2 min (n = 7): Group 2 - single-dose infusion of cardioplegia at the beginning of stop-flow ischemia (n = 8); and Group 3 - clamp ischemia (n = 3) without cardioplegia administration. Performance of the heart was assessed by rate-pressure product relative to the pre-ischemic level (RPP). An NMR method was applied which continuously detects the Na(i) concentration in the heart, using the ability of bound sodium to exhibit triple-quantum transitions and the growth of the corresponding signal when sodium ions pass from extracellular to intracellular space. Clamp ischemia without cardioplegia and 50 min of reperfusion left the heart dysfunctional, with Na(i) growth from the pre-ischemic level of 13.9 ± 1.2 mM to 34.9 ± 1.3 mM and 73.9 ± 1.9 mM at the end of ischemia and reperfusion, respectively. During single-dose cardioplegia the corresponding values for Na(i) were 30.2 ± 1 mM and 48.5 ± 1.7 mM (RPP 29%). Multiple infusions of cardioplegic solution resulted in a remarkable preservation of the heart's intracellular Na concentration with a non-significant increase in Na(i) during ischemia and only 16.7 ± 1 mM, (P = 0.01), after subsequent reperfusion (RPP = 85%). The time course of Na(i) changes in the rat heart model demonstrates a prominent potential of multi-dose St Thomas' cardioplegia in preserving intracellular sodium homeostasis at 37°C. The growth of Na(i) concentration during ischemia, as an indicator of the viability of the myocytes, can have a prognostic value for the heart's performance during reperfusion.

Original languageEnglish (US)
Pages (from-to)1643-1651
Number of pages9
JournalJournal of Molecular and Cellular Cardiology
Volume31
Issue number9
DOIs
StatePublished - Sep 1999
Externally publishedYes

Keywords

  • Cardioplegia
  • Intracellular sodium
  • NMR
  • Triple-quantum filtering

ASJC Scopus subject areas

  • Molecular Biology
  • Cardiology and Cardiovascular Medicine

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