Influence of the ph of cardioplegic solutions on cellular energy metabolism and hydrogen ion flux during neonatal hypothermic circulatory arrest and reperfusion:

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Presentation transcript:

Influence of the ph of cardioplegic solutions on cellular energy metabolism and hydrogen ion flux during neonatal hypothermic circulatory arrest and reperfusion: A dynamic 31p nuclear magnetic resonance study in a pig model Michael A. Portman, MDa, Anthony L. Panos, MDb, Yun Xiao, MDa, David L. Anderson, CCPb, George M. Alfieris, MDb, Xue-Han Ning, MDa, Flavian M. Lupinetti, MDb The Journal of Thoracic and Cardiovascular Surgery Volume 114, Issue 4, Pages 601-608 (October 1997) DOI: 10.1016/S0022-5223(97)70050-3 Copyright © 1997 Mosby, Inc. Terms and Conditions

Fig. 1 Functional parameters for each experimental group are shown: ACID, acidic cardioplegia; BASE, basic cardioplegia; NONE, no cardioplegia. Units of measurement for peak elastance and diastolic stiffness are mm Hg · ml–1 and for stroke work mm Hg · ml. *Significant differences versus group B. There are no significant differences between groups A and N (see text). Data are reported as means ± standard deviations. The Journal of Thoracic and Cardiovascular Surgery 1997 114, 601-608DOI: (10.1016/S0022-5223(97)70050-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Fig. 2 31P-NMR spectra from an individual experiment during ischemia and reperfusion. Spectra represent 16 seconds of acquisition (0.5-second interpulse delay) with 5000 Hz sweep width, operative frequency 81 MHz. Processing includes 8 Hz line broadening. Time course in experiment is noted at right (R indicates reperfusion). Stippled lines represent initial phosphocreatine assignment at 0 ppm and inorganic phosphate at 5.3 ppm. Note that inorganic phosphate peak increases in intensity and shifts up field (more positive) with respect to phosphocreatine during ischemia and shifts down field with reperfusion. The Journal of Thoracic and Cardiovascular Surgery 1997 114, 601-608DOI: (10.1016/S0022-5223(97)70050-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Fig. 3 Cytosolic H+ and phosphocreatine (PCr) changes during a 60-minute ischemia and recovery at 20° C are shown for an individual experiment. Ischemia begins at 0 minutes and reperfusion at 60 minutes. The slope of the solid line H+ plot represents the linear realkalinization rate. τH, the decay half-time, can be calculated by fitting an exponential curve to the reperfusion data. The curvilinear line results from such exponential fitting of phosphocreatine data; τPCr, equals 9.6 minutes in this particular experiment. The slope of the stippled lines represents the initial phosphocreatine depletion, which reflects the ATP use rate during ischemia. The Journal of Thoracic and Cardiovascular Surgery 1997 114, 601-608DOI: (10.1016/S0022-5223(97)70050-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Fig. 4 H+ concentration for each group is shown at different points in the protocol. Baseline is just before ischemia, peak is just before reperfusion, and recovery is 20 minutes after reperfusion (all at 20° C). Data are reported as means ± standard deviations. The Journal of Thoracic and Cardiovascular Surgery 1997 114, 601-608DOI: (10.1016/S0022-5223(97)70050-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Fig. 5 The initial realkalinization rate (ΔH+/time) at reperfusion is shown in the first panel. τ is the halftime of [H+] decrease calculated from exponential curve fitting. These data together indicate that realkalinization is slower in BASE. *Differences versus BASE. +Differences versus ACID. The Journal of Thoracic and Cardiovascular Surgery 1997 114, 601-608DOI: (10.1016/S0022-5223(97)70050-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Fig. 6 Initial rates of phosphocreatine change (ΔPCr) are shown for ischemia and reperfusion in each group. The rate of decrease of phosphocreatine during ischemia is much slower than the increase during reperfusion. There are no significant differences in phosphocreatine change/time during ischemia. Phosphocreatine recovery is slower in BASE (see text). *Differences versus BASE. Data reported as means ± standard deviations. The Journal of Thoracic and Cardiovascular Surgery 1997 114, 601-608DOI: (10.1016/S0022-5223(97)70050-3) Copyright © 1997 Mosby, Inc. Terms and Conditions