Systolic and diastolic function of both ventricles after prolonged cardioplegic arrest.
The current technique of donor heart preservation for transplantation is known to cause myocardial dysfunction. We have investigated the effect of 2, 4, and 8 hours of global ischemia at 4 degrees C with a single infusion of St. Thomas' Hospital cardioplegic solution on the recovery of right and left ventricular function in the blood-perfused, isolated pig heart. Two hours of ischemia caused significant deterioration in both left (p < 0.05) and right (p < 0.01) ventricular diastolic function as assessed by ventricular compliance and stiffness (reduction in left and right ventricular compliances, 19.3% +/- 14.8% and 13.3% +/- 3.5%, respectively) but had no significant effect on systolic function as evaluated by the slope value of the systolic pressure-volume relationship (peak elastance). Four hours of ischemia resulted in further reduction in ventricular compliance (left ventricle, p < 0.001; right ventricle, p < 0.05) and also caused left ventricular systolic dysfunction (p < 0.05). Eight hours of ischemia caused approximately 50% reduction in left ventricular (p < 0.01) and right ventricular (p < 0.05) compliance and left ventricular elastance (p < 0.001). Coronary vascular resistance at the end of 2 hours of reperfusion after preservation was significantly elevated as compared with the control value in all three groups. There was no correlation between the percentage increase in coronary vascular resistance and the percentage reduction in left or right ventricular diastolic function.(ABSTRACT TRUNCATED AT 250 WORDS)
Mankad
P S
PS
National Heart and Lung Institute, London, United Kingdom.
Yacoub
M H
MH
D000818:Animals; D001639:Bicarbonates; D002122:Calcium Chloride; D002314:Cardioplegic Solutions; D003187:Compliance; D003331:Coronary Vessels / Q000502:physiology; D003971:Diastole / Q000502:physiology*; D005260:Female; D006321:Heart / Q000033:anatomy & histology; D006324:Heart Arrest, Induced / Q000009:adverse effects*; D008274:Magnesium; D008297:Male; D011189:Potassium Chloride; D012965:Sodium Chloride; D013552:Swine; D013599:Systole / Q000502:physiology*; D013997:Time Factors; D014655:Vascular Resistance / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*
D001639:Bicarbonates; D002314:Cardioplegic Solutions; C041711:St. Thomas' Hospital cardioplegic solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D008274:Magnesium; D002122:Calcium Chloride