title: Left ventricular diastolic function of the reperfused postischemic donor heart.
abstract: This study examined the pathophysiological relationship between left ventricular diastolic function and myocardial biochemical changes during reperfusion following hypothermic cardioplegic preservation of the donor heart. Isolated canine hearts (n = 47) were preserved for 6 h at 5 degrees C, followed by normothermic reperfusion for 2 h. Regression analysis demonstrated a highly significant correlation between: Left ventricular maximum -dp/dt and the left ventricular end-diastolic pressure (r = -0.56, P = 0.001); myocardial concentrations of adenosine triphosphate (ATP) and Ca2+ (r = -0.59, P = 0.0001); maximum -dp/dt and myocardial concentrations of: (1) ATP, (2) Ca2+, and (3) total adenine nucleotide with left ventricular volume loading (r = -0.53, P = 0.003; r = 0.51, P = 0.002; and r = 0.52, P = 0.002, respectively); and left ventricular end-diastolic pressure and myocardial Ca2+ (r = 0.66, P = 0.0001). These results suggest that left ventricular relaxation, as assessed by maximum -dp/dt, has a negative correlation with left ventricular stiffness, as determined by the end-diastolic pressure in preserved donor hearts. Furthermore, increased myocardial Ca2+ concentrations reflect exhaustion of myocardial ATP. Thus, the myocardial Ca2+ concentration correlates directly with wall stiffness and inversely with ventricular relaxation, while ATP concentration correlates directly with ventricular relaxation.
authors.affiliation: Department of Thoracic-Cardiovascular Surgery, Tokyo Medical and Dental University, School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shirai
authors.forename: M
authors.initials: M
authors.lastname: Sunamori
authors.forename: A
authors.initials: A
authors.lastname: Suzuki
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D002118:Calcium / Q000378:metabolism; D003971:Diastole; D004285:Dogs; D006324:Heart Arrest, Induced; D066298:In Vitro Techniques; D009200:Myocardial Contraction; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism; D012044:Regression Analysis; D014019:Tissue Donors; D014021:Tissue Preservation; D016277:Ventricular Function, Left
chemical_list: D000255:Adenosine Triphosphate; D002118:Calcium