Spectroscopy of the isolated rabbit heart: effects of perfusion with oxygenated crystalloid cardioplegia at 4 degrees C and 20 degrees C.

Factors that limit survival of explanted cardiac allografts include intracellular acidosis and loss of high energy phosphates. This study was undertaken to determine if these processes could be retarded by specific interventions during organ storage and to determine the capabilities of phosphorus-31 (31P) nuclear magnetic resonance spectroscopy to monitor these intracellular changes noninvasively. Thirty-six excised rabbit hearts were studied in six groups according to the storage temperature and conditions of their perfusion: nonperfused, aerated perfusate or oxygenated perfusate, each at 4 degrees C and 20 degrees C. 31P spectra were continuously obtained starting 20 mins post explanation and continuing for at least 5 h. The resulting data were analyzed to determine metabolite concentration and intracellular pH. The phosphodiesters, inorganic phosphates and phosphomonoesters, as well as the phosphocreatine and adenosine triphosphate peaks, could be reproducibly resolved. Comparisons at 0.5, 1, 2, 3, 4, and 5 h indicated that high energy phosphates were the most quickly degraded, and intracellular acidosis progressed most rapidly in nonperfused hearts at 20 degrees C. Hearts perfused with oxygenated cardioplegic solution at 4 degrees C showed significantly prolonged preservation of high energy phosphates and delayed development of intracellular acidosis. It was concluded that continuous infusion of oxygenated cardioplegic solution improves preservation of high energy phosphates at low temperatures, and that 31P magnetic resonance spectroscopy can be used to monitor these important intracellular changes rapidly and nonivasively, permitting serial studies on the same heart. This technique substantially reduced the number of animals needed for the study (36 were used in this study rather than the 216 required by traditional techniques).