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Effects of calcium in continuous cardioplegia on myocardial protection
Authors:Naoaki Takemoto  Hiroaki Kuroda  Yoshinobu Nakamura  Takashi Ichiba  Naruto Matsuda  Yasushi Ashida  Takafumi Hamasaki  Yohichi Hara  Shingo Ishiguro  Tohru Mori
Affiliation:(1) Second Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishi-machi, Yonago, 683 Tottori, Japan
Abstract:The effects of calcium (Ca) on a hyperkalemic cardioplegic solution for continuous cardioplegia were examined in an isolated perfused working rat heart model. The coronary arteries were perfused with a modified Krebs-Henseleit bicarbonate buffer (K-H) solution, containing various concentrations of Ca(0.1, 0.6, 1.2, and 2.5 mmol/l) and a high concentration of potassium (20 mmol/l), for 180 min, after which cardiac arrest was induced at 37°C for 180 min. Cardiac function and creatine kinase (CK) were measured. In the control group, K-H solution was infused in place of the cardioplegic solution, and cardiac arrest was not induced. No significant differences were observed between the groups infused with the K-H solution containing Ca concentrations of 0.6, 1.2, and 2.5 mmol/l in the percent recovery of aortic flow (82.1±2.9%, 80.6±2.0%, and 71.5±3.7% (mean±SEM) respectively) or in the recovery of other indices of cardiac function, or in CK leakage. There were also no significant differences in the recovery of cardiac function and CK leakage between these groups and the control group. In the Ca 0.1 mmol/l group, however, the characteristic Ca paradox was observed. These findings suggest that if the Ca concentration in a cardioplegic solution is higher than 0.6 mmol/l during continuous cardioplegia, excellent cardioprotective effects will be achieved.
Keywords:calcium  continuous cardioplegia  cardiac arrest  myocardial protection  calcium paradox
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