Abstract
Background and aim of the study: Simultaneous antegrade/retrograde cardioplegia (SARC) has been employed frequently during cardiac surgery to preserve the jeopardized myocardium. However, retrograde perfusion of SARC may interfere with myocardial drainage and disrupt myocardial fluid homeostasis, which may affect the myocardial energy metabolism and contractile function. The study was, therefore, designed to assess the effects of SARC on myocardial fluid homeostasis, cellular volumes, and energy metabolism. Methods: Eight isolated pig hearts were subjected to a protocol consisting of a 20-minute control perfusion, 120-minute SARC, and 20-minute reperfusion. The myocardial water content was monitored using near-infrared spectroscopy. Phosphorus-31 magnetic resonance (31P MR) spectroscopy was used to monitor the volumes of both intracellular and extracellular compartments and assess myocardial energy metabolism. Results: The near-infrared spectra showed that the 120-min SARC resulted in a 60 ± 12% increase in the myocardial water content. 31P MR spectra showed a 36 ± 4% increase in the intracellular compartment and a 54 ± 8% increase in the extracellular compartment during SARC relative to their initial volumes measured during control perfusion (100%). However, the myocardial energy metabolites (adenosine triphosphate [ATP] and phosphocreatine [PCr]) remained unchanged during the 120-minute SARC. Moreover, during reperfusion, the hearts showed an almost complete recovery in the left ventricular-developed pressure. Conclusions: A prolonged SARC resulted in water accumulation in both extracellular and intracellular compartments in the normal myocardium. Although its detrimental effect on tissue fluid homeostasis did not jeopardize the myocardial energy metabolism, a prolonged use of SARC should be avoided, particularly in the diseased hearts.
| Original language | English |
|---|---|
| Pages (from-to) | 437-443 |
| Number of pages | 7 |
| Journal | Journal of Cardiac Surgery |
| Volume | 23 |
| Issue number | 5 |
| DOIs | |
| State | Published - Oct 1 2008 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
The effects of simultaneous antegrade/retrograde cardioplegia on cellular volumes and energy metabolism. / Li, Gang; Tian, Weichen; Wang, Jian; Xiang, Bo; Wang, Lei; Deng, Jixian; Salerno, Tomas; Deslauriers, Roxanne; Tian, Ganghong.
In: Journal of Cardiac Surgery, Vol. 23, No. 5, 01.10.2008, p. 437-443.Research output: Contribution to journal › Article
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TY - JOUR
T1 - The effects of simultaneous antegrade/retrograde cardioplegia on cellular volumes and energy metabolism
AU - Li, Gang
AU - Tian, Weichen
AU - Wang, Jian
AU - Xiang, Bo
AU - Wang, Lei
AU - Deng, Jixian
AU - Salerno, Tomas
AU - Deslauriers, Roxanne
AU - Tian, Ganghong
PY - 2008/10/1
Y1 - 2008/10/1
N2 - Background and aim of the study: Simultaneous antegrade/retrograde cardioplegia (SARC) has been employed frequently during cardiac surgery to preserve the jeopardized myocardium. However, retrograde perfusion of SARC may interfere with myocardial drainage and disrupt myocardial fluid homeostasis, which may affect the myocardial energy metabolism and contractile function. The study was, therefore, designed to assess the effects of SARC on myocardial fluid homeostasis, cellular volumes, and energy metabolism. Methods: Eight isolated pig hearts were subjected to a protocol consisting of a 20-minute control perfusion, 120-minute SARC, and 20-minute reperfusion. The myocardial water content was monitored using near-infrared spectroscopy. Phosphorus-31 magnetic resonance (31P MR) spectroscopy was used to monitor the volumes of both intracellular and extracellular compartments and assess myocardial energy metabolism. Results: The near-infrared spectra showed that the 120-min SARC resulted in a 60 ± 12% increase in the myocardial water content. 31P MR spectra showed a 36 ± 4% increase in the intracellular compartment and a 54 ± 8% increase in the extracellular compartment during SARC relative to their initial volumes measured during control perfusion (100%). However, the myocardial energy metabolites (adenosine triphosphate [ATP] and phosphocreatine [PCr]) remained unchanged during the 120-minute SARC. Moreover, during reperfusion, the hearts showed an almost complete recovery in the left ventricular-developed pressure. Conclusions: A prolonged SARC resulted in water accumulation in both extracellular and intracellular compartments in the normal myocardium. Although its detrimental effect on tissue fluid homeostasis did not jeopardize the myocardial energy metabolism, a prolonged use of SARC should be avoided, particularly in the diseased hearts.
AB - Background and aim of the study: Simultaneous antegrade/retrograde cardioplegia (SARC) has been employed frequently during cardiac surgery to preserve the jeopardized myocardium. However, retrograde perfusion of SARC may interfere with myocardial drainage and disrupt myocardial fluid homeostasis, which may affect the myocardial energy metabolism and contractile function. The study was, therefore, designed to assess the effects of SARC on myocardial fluid homeostasis, cellular volumes, and energy metabolism. Methods: Eight isolated pig hearts were subjected to a protocol consisting of a 20-minute control perfusion, 120-minute SARC, and 20-minute reperfusion. The myocardial water content was monitored using near-infrared spectroscopy. Phosphorus-31 magnetic resonance (31P MR) spectroscopy was used to monitor the volumes of both intracellular and extracellular compartments and assess myocardial energy metabolism. Results: The near-infrared spectra showed that the 120-min SARC resulted in a 60 ± 12% increase in the myocardial water content. 31P MR spectra showed a 36 ± 4% increase in the intracellular compartment and a 54 ± 8% increase in the extracellular compartment during SARC relative to their initial volumes measured during control perfusion (100%). However, the myocardial energy metabolites (adenosine triphosphate [ATP] and phosphocreatine [PCr]) remained unchanged during the 120-minute SARC. Moreover, during reperfusion, the hearts showed an almost complete recovery in the left ventricular-developed pressure. Conclusions: A prolonged SARC resulted in water accumulation in both extracellular and intracellular compartments in the normal myocardium. Although its detrimental effect on tissue fluid homeostasis did not jeopardize the myocardial energy metabolism, a prolonged use of SARC should be avoided, particularly in the diseased hearts.
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U2 - 10.1111/j.1540-8191.2008.00690.x
DO - 10.1111/j.1540-8191.2008.00690.x
M3 - Article
VL - 23
SP - 437
EP - 443
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
SN - 0886-0440
IS - 5
ER -