Correlation among Water Content, Left Ventricular Function, Coronary Blood Flow, and Myocardial Metabolism after Hypothermic Ischemic Cardiac Arrest
Subendocardial ischemia is a common cause of death following ischemic cardiac arrest. We studied relationships among myocardial water content (WC), left ventricular function, coronary blood flow, and myocardial metabolism following ischemic cardiac arrest. Under cardiopulmonary bypass with hypothermia, 120 min of aortic occlusion was employed, and myocardial temperature was kept around 20°C in 10 mongrel dogs. Left ventricular function (peak LVP, max dp/dt, LVEDP, LVSWI), coronary blood flow, myocardial enzymes (m-GOT, total CPK, MB-CPK), myocardial ATP and creatine phosphate (CP), and WC of the suben-docardium of the left ventricle were measured. Data were obtained in the control state and immediately and 30 and 60 min after aortic unclamping. Significant negative correlations were obtained between WC and max dp/dt (r = -0.8384), coronary blood flow (r = -0.9928), ATP (r = -0.7038), and CP (r = -0.7835). Significant positive correlations were obtained between WC and LVEDP (r = 0.7525), m-GOT (r = 0.7638), and total CPK (r = 0.7079). These data suggest that myocardial edema results in depression of left ventricular function and metabolism.
KeywordsCoronary Blood Flow Creatine Phosphate Myocardial Edema Subendocardial Ischemia Ventricular Stroke Work Index
Unable to display preview. Download preview PDF.
- 1.Allen, W. B., Blackstone, E. H., and Kouchoukos, N. T. 1974. Effects of cardiopulmonary bypass and ischemic cardioplegia on the diastolic pressure-volume relationship and water content of the canine left ventricle. Circulation 49/50(Suppl.):III–19.Google Scholar
- 4.De Gasperis, C, Gonzales-Lavin, L., Pellegrini, A., and Ross, D. N. 1971/72. Ultrastruc-tural aspects of human myocardial capillaries during open heart surgery. Cardiology 56:333–336.Google Scholar
- 8.Mukherjee, A., Buja, L. M., Scales, G. C, Fink, G. C., Templeton, G. H., Platt, M. R., and Willerson, J. T. 1978. Abnormal myocardial fluid retention as an early manifestation of ischemic injury. In: T. Kobayashi, Y. Ito, and G. Rona (eds.), Recent Advances in Studies on Cardiac Structure and Metabolism. Vol. 12: Cardiac Adaptation, pp. 245–252. University Park Press, Baltimore.Google Scholar
- 11.Utley, J. R., Michalsky, G. B., Bryant, L. R., Mobin-Uddin, K., and McKean, H. E. 1973. Determinants of myocardial water content during cardiopulmonary bypass. J. Thorac’ Cardiovasc. Surg. 68:8–16.Google Scholar
- 12.Wahlen, D. A., Hamilton, D. G., Ganote, C. E., and Jennings, R. B. 1974. Effect of a transient period of ischemia on myocardial cells: 1. Effects on cell volume regulation. Am. J. Cardiol. 74:381–397.Google Scholar