Long-term myocardial preservation: effects of hyperkalemia, sodium channel, and NA+/K+/2CL- cotransport inhibition on extracellular potassium accumulation.

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Presentation transcript:

Long-term myocardial preservation: effects of hyperkalemia, sodium channel, and NA+/K+/2CL- cotransport inhibition on extracellular potassium accumulation during hypothermic storage Andrew K. Snabaitis, PhD a, Michael J. Shattock, PhD b, David J. Chambers, PhDa The Journal of Thoracic and Cardiovascular Surgery Volume 118, Issue 1, Pages 123-134 (July 1999) DOI: 10.1016/S0022-5223(99)70151-0 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 1 The experimental protocols for study A and study B are represented diagrammatically. The arrows indicate the stage during the protocol at which the electrodes were inserted into the myocardium. LM, Langendorff mode; WM, working mode; CI, cardioplegic infusion; KH, Krebs-Henseleit; TTX, tetrodotoxin. The Journal of Thoracic and Cardiovascular Surgery 1999 118, 123-134DOI: (10.1016/S0022-5223(99)70151-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 2 Diagrammatic representation of a cross section through a “side-window” PVC/valinomycin electrode, showing the electrode stitched into the left ventricular wall ( LVW) for on-line determination of myocardial K+ e during long-term preservation. The Journal of Thoracic and Cardiovascular Surgery 1999 118, 123-134DOI: (10.1016/S0022-5223(99)70151-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 3 All hearts were initially perfused in the working mode for 10 minutes before cardioplegic arrest and hypothermic (7.5°C) storage for 5 hours. Changes in myocardial K+ e (mmol/L) were then determined with potassium-sensitive “side-window” flexible electrodes. A, Hearts were arrested and stored with Krebs-Henseleit buffer alone (control: open circles), high K+ (open squares ), or tetrodotoxin (filled circles). Arrow indicates onset of reperfusion; n = 6 hearts per group. B, Hearts were arrested and stored with Krebs-Henseleit buffer + 22 μmol/L tetrodotoxin + 0.1% methanol (control; filled circles), control + 0.1 μmol/L (open squares), 1.0 μmol/L ( filled squares), 10 μmol/L (open triangles ), and 100 μmol/L (filled triangles) furosemide; n = 4 hearts per group. Arrow indicates time of freeze-clamping of hearts for tissue weight determination. All values represent the mean ± standard error of mean; baseline K +e during preischemic aerobic perfusion and postischemic reperfusion was equal to that of the Krebs-Henseleit buffer perfusate (5.93 mmol/L). The Journal of Thoracic and Cardiovascular Surgery 1999 118, 123-134DOI: (10.1016/S0022-5223(99)70151-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 4 A, Rate of change in myocardial K+e during 5 hours of hypothermic (7.5°C) ischemic storage in hearts arrested and stored with Krebs-Henseleit buffer alone (control; open circles), high K+ ( open squares), or tetrodotoxin (filled circles ). Values represent the mean of 6 hearts per group; standard errors have been omitted for clarity. Note the change in scale along the time axis between 0-60 and 60-300 minutes. B, Rate of change in myocardial K+e during 5 hours of hypothermic (7.5°C) ischemic storage of hearts arrested and stored with Krebs-Henseleit buffer + 22 μmol/L tetrodotoxin + 0.1% methanol (control; filled circles) or control + 0.1 μmol/L ( open squares), 1.0 μmol/L (filled squares ), 10 μmol/L (open triangles), and 100 μmol/L (filled triangles) furosemide. Values represent the mean of n = 4 hearts per group; standard errors have been omitted for clarity. Note the change in scale along the time axis between 0-60 and 60-300 minutes. The Journal of Thoracic and Cardiovascular Surgery 1999 118, 123-134DOI: (10.1016/S0022-5223(99)70151-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 5 A, Postischemic recovery of aortic flow after 30 minutes of working mode reperfusion after K+ e determination during 5 hours of hypothermic (7.5°C) ischemic arrest and storage with either Krebs-Henseleit buffer alone (control) or high K + and tetrodotoxin. Values are expressed as a percent of preischemic control value. Columns represent mean ± standard error of mean. *P < .05 versus control, n = 6 hearts per group. B, Postischemic recovery of aortic flow after 30 minutes of working mode reperfusion after 5 hours of hypothermic (7.5°C) storage of hearts arrested and stored with 22 μmol/L tetrodotoxin + 0.1% methanol (control) or control + 0.1, 1.0, 10, or 100 μmol/L furosemide. Columns represent mean ± standard error of mean; *P < .05 versus control, n = 8 hearts per group. The Journal of Thoracic and Cardiovascular Surgery 1999 118, 123-134DOI: (10.1016/S0022-5223(99)70151-0) Copyright © 1999 Mosby, Inc. Terms and Conditions