Tian G, Biro G P, Butler K W, Xiang B, Vu C, Deslauriers R
Department of Physiology, Faculty of Medicine, University of Ottawa, Ontario, Canada.
J Heart Lung Transplant. 1993 Jan-Feb;12(1 Pt 1):81-8.
We have studied the effects of adding 0.5 mmol/L CaCl2 to University of Wisconsin solution (0.08 mmol/L free Ca++) on hypothermic heart preservation. Isolated pig hearts were subjected to 8 hours of preservation at 12 degrees C; eight hearts were arrested with Ca++ free University of Wisconsin solution, and seven hearts were arrested with Ca(++)-containing University of Wisconsin solution. The recovery of contractile function was evaluated by measuring isovolumic ventricular pressure development. 31P nuclear magnetic resonance spectroscopy was used to monitor the changes in high-energy phosphates. Compared to the hearts arrested with the Ca(++)-free University of Wisconsin solution, the heart arrested with the Ca(++)-containing University of Wisconsin solution showed significantly improved (p < 0.001) contractile functional recovery. No "stone heart" or loss of high-energy phosphates was observed on reperfusion. The hearts showed an increase in diastolic pressure during infusion of the Ca(++)-containing University of Wisconsin solution, however, to show the relationship between the addition of calcium and the increase in diastolic pressure, a second protocol was performed. A 30-minute period of ischemia was induced in thirteen hearts that were arrested at 12 degrees C with either Ca(++)-containing University of Wisconsin solution (n = 8) or Ca(++)-free University of Wisconsin solution (n = 5). Diastolic pressure was monitored during ischemia while ventricular volume was maintained constant with a balloon. The hearts arrested with the Ca(++)-containing University of Wisconsin solution showed a mean rise of 5 mm Hg in diastolic pressure and a rapid decline of phosphocreatine (p < 0.001). Our results suggest that, although 0.08 mmol/L free Ca++ improves functional recovery after 8 hours of heart preservation with University of Wisconsin solution at 12 degrees C, it can increase diastolic pressure during ischemia and accelerate breakdown of the high-energy phosphate stores in the myocardium, suggesting that use of University of Wisconsin solution containing 0.5 mmol/L CaCl2 may result in a significant increase in the intracellular calcium level.
我们研究了在威斯康星大学溶液（游离钙离子浓度为0.08 mmol/L）中添加0.5 mmol/L氯化钙对低温心脏保存的影响。将离体猪心在12℃下保存8小时；8颗心脏用无钙离子的威斯康星大学溶液停跳，7颗心脏用含钙离子的威斯康星大学溶液停跳。通过测量等容心室压力变化来评估收缩功能的恢复情况。采用31P核磁共振波谱法监测高能磷酸盐的变化。与用无钙离子的威斯康星大学溶液停跳的心脏相比，用含钙离子的威斯康星大学溶液停跳的心脏收缩功能恢复明显改善（p < 0.001）。再灌注时未观察到“石心”现象或高能磷酸盐的丢失。在用含钙离子的威斯康星大学溶液灌注期间，心脏舒张压升高，然而，为了显示钙添加与舒张压升高之间的关系，又进行了第二个实验方案。对13颗在12℃下用含钙离子的威斯康星大学溶液（n = 8）或无钙离子的威斯康星大学溶液（n = 5）停跳的心脏诱导30分钟缺血。缺血期间监测舒张压，同时用球囊维持心室容积恒定。用含钙离子的威斯康星大学溶液停跳的心脏舒张压平均升高5 mmHg，磷酸肌酸迅速下降（p < 0.001）。我们的结果表明，虽然0.08 mmol/L游离钙离子可改善威斯康星大学溶液在12℃下保存8小时后的心脏功能恢复，但它可在缺血期间增加舒张压并加速心肌中高能磷酸盐储备的分解，这表明使用含0.5 mmol/L氯化钙的威斯康星大学溶液可能导致细胞内钙水平显著升高。
