Boggs B R, Torchiana D F, Geffin G A, Titus J S, Redonnett B E, O'Keefe D D, Newell J B, Daggett W M
J Thorac Cardiovasc Surg. 1987 Jun;93(6):838-46.
The effect of the calcium and oxygen contents of a hyperkalemic glucose-containing cardioplegic solution on myocardial preservation was examined in the isolated working rat heart. The cardioplegic solution was delivered at 4 degrees C every 15 minutes during 2 hours of arrest, maintaining a myocardial temperature of 8 degrees +/- 2 degrees C. Hearts were reperfused in the Langendorff mode for 15 minutes and then resumed the working mode for a further 30 minutes. Groups of hearts were given the oxygenated cardioplegic solution containing an ionized calcium concentration of 0, 0.25, 0.75, or 1.25 mmol/L or the same solution nitrogenated to reduce the oxygen content and containing 0 or 0.75 mmol ionized calcium per liter. The myocardial adenosine triphosphate concentrations at the end of arrest in these six groups of hearts were 15.6 +/- 1.2, 9.5 +/- 0.5, 8.2 +/- 1.1, 4.9 +/- 1.8, 10.1 +/- 2.0, and 1.6 +/- 0.4 nmol/mg dry weight, respectively. At 5 minutes of working reperfusion, the percentages of prearrest aortic flow were 80 +/- 2, 62 +/- 4, 33 +/- 6, 37 +/- 5, 48 +/- 7 and 46 +/- 8, respectively. The differences among the groups in adenosine triphosphate concentrations and in functional recovery diminished during reperfusion. In hearts given the hypoxic calcium-containing solution, there was a marked increase in coronary vascular resistance during the administration of successive doses of cardioplegic solution, which was rapidly reversible upon reperfusion. These data indicate that hearts given the acalcemic oxygenated solution had better adenosine triphosphate preservation during arrest and better functional recovery than hearts in any other group. Addition of calcium to the oxygenated cardioplegic solution decreased adenosine triphosphate preservation and functional recovery. Oxygenation of the acalcemic solution increased adenosine triphosphate preservation and functional recovery. The lowest adenosine triphosphate levels at end arrest were observed in hearts given the hypoxic calcium-containing solution. In the setting of hypothermia and multidose administration, the addition of calcium to a cardioplegic solution resulted in increased energy depletion during arrest and depressed recovery.
在离体工作大鼠心脏中，研究了高钾含葡萄糖心脏停搏液中钙和氧含量对心肌保存的影响。在心脏停搏2小时期间，每隔15分钟在4℃下给予心脏停搏液，使心肌温度维持在8℃±2℃。心脏在Langendorff模式下再灌注15分钟，然后恢复工作模式再持续30分钟。给心脏分组给予离子钙浓度为0、0.25、0.75或1.25 mmol/L的氧合心脏停搏液，或给予相同溶液经氮气处理以降低氧含量且每升含0或0.75 mmol离子钙的溶液。这六组心脏在停搏结束时的心肌三磷酸腺苷浓度分别为15.6±1.2、9.5±0.5、8.2±1.1、4.9±1.8、10.1±2.0和1.6±0.4 nmol/mg干重。在工作再灌注5分钟时，停搏前主动脉流量的百分比分别为80±2、62±4、33±6、37±5、48±7和46±8。再灌注期间，各组之间三磷酸腺苷浓度和功能恢复的差异减小。给予缺氧含钙溶液的心脏，在连续给予心脏停搏液期间冠状动脉血管阻力显著增加，再灌注时迅速恢复正常。这些数据表明，给予无钙氧合溶液的心脏在停搏期间三磷酸腺苷保存更好，功能恢复比其他任何组的心脏都好。向氧合心脏停搏液中添加钙会降低三磷酸腺苷保存和功能恢复。无钙溶液的氧合增加了三磷酸腺苷保存和功能恢复。给予缺氧含钙溶液的心脏在停搏结束时三磷酸腺苷水平最低。在低温和多剂量给药的情况下，向心脏停搏液中添加钙会导致停搏期间能量消耗增加和恢复受损。
