使用威斯康星大学溶液、钙和镁进行心脏保存。

Cardiac storage with University of Wisconsin solution, calcium, and magnesium.

作者信息

Fremes S E, Zhang J, Furukawa R D, Mickle D A, Weisel R D

机构信息

Division of Cardiovascular Surgery, Centre for Cardiovascular Research University of Toronto, Ontario, Canada.

出版信息

J Heart Lung Transplant. 1995 Sep-Oct;14(5):916-25.

PMID:8800728

Abstract

BACKGROUND

Previous investigations from this institution and others support the role of University of Wisconsin solution for prolonged hypothermic cardiac storage. Modification of the divalent cation concentrations has been beneficial for cardioplegic investigations and may enhance cardiac recovery after extended preservation.

METHODS

To investigate this hypothesis, isolated rodent hearts were obtained from Sprague-Dawley rats and mounted on a Langendorff apparatus. Rat hearts were flushed (15 ml/kg) and stored (30 ml) for 8 hours at 0 degree C in unmodified University of Wisconsin solution (n = 16/group) or University of Wisconsin solution with calcium concentrations of 0.025 to 10 mmol/L or magnesium concentrations of 10 to 20 mmol/L (six to eight hearts/group). Finally, combinations of calcium and magnesium were examined. Rat hearts were studied before storage and after 45 minutes of reperfusion with an intraventricular balloon.

RESULTS

Developed pressure (mean +/- standard deviation) was increased with calcium 0.1 mmol/L (University of Wisconsin solution: 69.2% +/- 7.0%; Ca++ 0.1 mmol/L: 78.9% +/- 6.1%, p < 0.05), whereas only the addition of the highest calcium concentration (10 mmol/L) was significantly harmful (developed pressure: 58.3% +/- 8.4%, p < 0.05; creatine kinase release: 408 +/- 200 versus 170 +/- 104 IU/gm, p < 0.05; lactate dehydrogenase release: 103 +/- 43 versus 37 +/- 26 IU/gm, p < 0.05). Coronary flow recovered to control values with magnesium 15 mmol/L, which was significantly greater than that achieved with unmodified University of Wisconsin solution (97.1% +/- 14.6% versus 72.1% +/- 8.4%, p < 0.05). Of the calcium-magnesium combinations tested, developed pressure was increased compared with unmodified University of Wisconsin solution with calcium 0.1 and magnesium 20 mmol/L (76.8% +/- 6.4%, p < 0.05). Diastolic function was reduced in all groups (p < 0.0001) and not significantly different between groups.

CONCLUSIONS

The experiments indicated that recovery after storage with University of Wisconsin solution is enhanced with the addition of calcium and magnesium. The addition of high concentrations of calcium (> or = 2.5 mmol/L) appears harmful.

摘要

背景

该机构及其他机构先前的研究支持威斯康星大学溶液在长时间低温心脏保存中的作用。二价阳离子浓度的改变对心脏停搏液的研究有益，且可能增强长时间保存后的心脏恢复。

方法

为研究该假设，从Sprague-Dawley大鼠获取离体心脏并安装在Langendorff装置上。大鼠心脏以15ml/kg冲洗，在0℃下于未改良的威斯康星大学溶液（每组16个）或钙浓度为0.025至10mmol/L或镁浓度为10至20mmol/L的威斯康星大学溶液中保存8小时（每组6至8个心脏）。最后，检测钙和镁的组合。在保存前及用室内球囊再灌注45分钟后对大鼠心脏进行研究。

结果

添加0.1mmol/L钙时，发展压力（均值±标准差）增加（威斯康星大学溶液：69.2%±7.0%；Ca++ 0.1mmol/L：78.9%±6.1%，p<0.05），而仅添加最高钙浓度（10mmol/L）有显著危害（发展压力：58.3%±8.4%，p<0.05；肌酸激酶释放：408±200对170±104IU/gm，p<0.05；乳酸脱氢酶释放：103±43对37±26IU/gm，p<0.05）。添加15mmol/L镁时冠状动脉血流恢复至对照值，显著高于未改良的威斯康星大学溶液（97.1%±14.6%对72.1%±8.4%，p<0.05）。在所测试的钙镁组合中，添加0.1mmol/L钙和20mmol/L镁时与未改良的威斯康星大学溶液相比发展压力增加（76.8%±6.4%，p<0.05）。所有组舒张功能均降低（p<0.0001），组间无显著差异。