Forty-hour preservation of the rabbit heart: optimal osmolarity, [Mg2+], and pH of a modified UW solution.
The University of Wisconsin solution modified with 2,3-butanedione monoxime and calcium experimentally extends the limits of ischemic preservation of the heart. This study evaluates other characteristics of this modified solution that may further enhance preservation: osmolarity, Mg2+ concentration ([Mg2+]), and pH. Rabbit hearts were flushed with the modified University of Wisconsin solution and stored for 40 hours at 4 degrees C. Maximal left ventricular developed pressure (LVDP), left ventricular end-diastolic volume (LVEDV), maximum rate of increase of left ventricular pressure (dP/dt), heart rate, and coronary flow were measured during 60 minutes of isolated crystalloid reperfusion with an isovolumic left ventricular balloon at constant end-diastolic pressure. Creatine kinase release and myocardial adenine nucleotide content were measured at completion of reperfusion. Solution osmolarity was tested at 357, 327, 297, and 277 mOsm/L by reducing K+, Na+, and lactobionate concentrations. [Mg2+] was assessed at 5 and 16 mmol/L. Solution pH was studied at 7.0, 7.4, and 7.8. A control group of hearts was flushed and immediately reperfused to establish baseline function. Hearts stored in either hypertonic (357 mOsm/L) or hypotonic (277 mOsm/L) solutions functioned poorly, reaching 58% and 50% of control LVDP (p < 0.001), 49% (p < 0.01), and 58% (p = not significant) of LVEDV, 56% and 49% of +dP/dt (p < 0.001), respectively, and released substantially more creatine kinase (p < 0.001 versus control).(ABSTRACT TRUNCATED AT 250 WORDS)
Division of Cardiothoracic Surgery, University of Wisconsin Hospital and Clinics, Madison 53792.
J C
JC
Stringham
K L
KL
Paulsen
J H
JH
Southard
R M
RM
Mentzer
F O
FO
Belzer
D000241:Adenosine / Q000737:chemistry; D000493:Allopurinol / Q000737:chemistry; D000818:Animals; D002118:Calcium; D002314:Cardioplegic Solutions / Q000737:chemistry*; D002863:Chromogenic Compounds; D003402:Creatine Kinase / Q000378:metabolism; D003931:Diacetyl / Q000031:analogs & derivatives*; D005978:Glutathione / Q000737:chemistry; D016027:Heart Transplantation / Q000502:physiology; D006863:Hydrogen-Ion Concentration; D007328:Insulin / Q000737:chemistry; D008274:Magnesium; D009200:Myocardial Contraction / Q000187:drug effects; D009206:Myocardium / Q000201:enzymology; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D009994:Osmolar Concentration; D011817:Rabbits; D011887:Raffinose / Q000737:chemistry; D013997:Time Factors; D016276:Ventricular Function / Q000187:drug effects
D002314:Cardioplegic Solutions; D002863:Chromogenic Compounds; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; C004717:diacetylmonoxime; D000493:Allopurinol; D003402:Creatine Kinase; D005978:Glutathione; D008274:Magnesium; D003931:Diacetyl; D000241:Adenosine; D011887:Raffinose; D002118:Calcium