Effect of crystalloid cardioplegia and verapamil on cardiac function and cellular biochemistry during hypothermic cardiac arrest.

A study was undertaken to assess the effectiveness of cold crystalloid cardioplegia with or without verapamil on the functional recovery of the heart, Ca++ binding and uptake, Ca++ ATPase of sarcoplasmic reticulum, sarcolemmal ATPase and the MB fraction of creatine kinase (MBCK) after 1.5 h of reperfusion following 1 h of ischemic cardiac arrest. The dogs were divided into three groups: group I, sham bypass; group II, cold crystalloid cardioplegia; group III, cold crystalloid cardioplegia with verapamil. There was a decrease in the cardiac index (CI), left ventricular work index (LVWI) and mean aortic pressure (MAP) in the sham bypass group at the end of the protocol (time period corresponding to 60 mins off bypass). There was a decrease in the Cl and index of myocardial contractility in the cold crystalloid cardioplegic group compared to sham bypass group. The decrease in the cardiac function in cold crystalloid group was associated with a decrease in Ca++ uptake by sarcoplasmic reticulum and a tendency for an increase in the sarcolemmal Na+-K+ ATPase. The Ca++ binding and the Ca++ ATPase of sarcoplasmic reticulum were not affected. The index of myocardial contractility and cardiac function were better with cold crystalloid containing verapamil than with cold crystalloid alone. This improvement, although partial, in cardiac contractility and function with cold crystalloid cardioplegia containing verapamil was associated with an improvement in the Ca++ uptake by the sarcoplasmic reticulum. The Ca++ ATPase and Ca++ binding were depressed in group III. The MBCK in systemic and coronary sinus blood increased progressively in groups II and III. Although there was an increase in MBCK in group I the increase was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)