Starr J P, Jia C X, Amirhamzeh M M, Rabkin D G, Hart J P, Hsu D T, Fisher P E, Szabolcs M, Spotnitz H M
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
Ann Thorac Surg. 1999 Sep;68(3):925-30. doi: 10.1016/s0003-4975(99)00688-8.
Recent studies found that edema, histology, and left ventricular diastolic compliance exhibit quantitative relationships in rats. Edema due to low osmolarity coronary perfusates increases myocardial water content and histologic edema score and decreases left ventricular filling. The present study examined effects of perfusate osmolarity and chemical composition on rat hearts.
Arrested American Cancer Institute (ACI) rat hearts (4 degrees C) were perfused with different cardioplegia solutions, including Plegisol (289 mOsm/L), dilute Plegisol (172 mOsm/L), Stanford solution (409 mOsm/L), and University of Wisconsin solution (315 mOsm/L). Controls had blood perfusion (310 mOsm/L). Postmortem left ventricular pressure-volume curves and myocardial water content were measured. After glutaraldehyde or formalin fixation, dehydration, and paraffin embedding, edema was graded subjectively.
Myocardial water content reflected perfusate osmolarity, being lowest in Stanford and University of Wisconsin solutions (p<0.05 versus other groups) and highest in dilute Plegisol (p<0.05). Left ventricular filling volumes were smallest in dilute Plegisol and Plegisol (p<0.05). Osmolarity was not a major determinant of myocardial edema grade, which was highest with University of Wisconsin solution and dilute Plegisol (p<0.05 versus other groups).
Perfusate osmolarity determined myocardial water content and left ventricular filling volume. However, perfusate chemical composition influenced the histologic appearance of edema. Pathologic grading of edema can be influenced by factors other than osmolarity alone.
最近的研究发现,大鼠的水肿、组织学变化和左心室舒张顺应性之间存在定量关系。低渗透压冠状动脉灌注液引起的水肿会增加心肌含水量和组织学水肿评分,并降低左心室充盈。本研究检测了灌注液渗透压和化学成分对大鼠心脏的影响。
将处于停搏状态的美国癌症研究所(ACI)大鼠心脏(4℃)用不同的心脏停搏液进行灌注,包括普列吉索尔液(289 mOsm/L)、稀释普列吉索尔液(172 mOsm/L)、斯坦福液(409 mOsm/L)和威斯康星大学液(315 mOsm/L)。对照组进行血液灌注(310 mOsm/L)。测量死后左心室压力-容积曲线和心肌含水量。在戊二醛或福尔马林固定、脱水和石蜡包埋后,主观评定水肿程度。
心肌含水量反映灌注液渗透压,在斯坦福液和威斯康星大学液中最低(与其他组相比,p<0.05),在稀释普列吉索尔液中最高(p<0.05)。稀释普列吉索尔液和普列吉索尔液中的左心室充盈量最小(p<0.05)。渗透压不是心肌水肿程度的主要决定因素,威斯康星大学液和稀释普列吉索尔液中的水肿程度最高(与其他组相比,p<0.05)。
灌注液渗透压决定心肌含水量和左心室充盈量。然而,灌注液化学成分影响水肿的组织学表现。水肿的病理分级可能受渗透压以外的其他因素影响。