Principles and Problems
  • Hans Jürgen Bretschneider
  • Martha Maria Gebhard
  • Claus Jürgen Preusse
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 34)


Interruption of the coronary circulation with ensuing depletion of cardiac oxygen reserves and shift from aerobic to anaerobic energy gain leads to disturbances of contractile function, to acidosis and changes in electrolyte and water distribution between intracellular and extracellular compartments, and thereby to disturbances of basic electrophysiologic processes, to structural alterations, and, finally, to organ death. Irreversible damage to the left ventricular myocardial muscle occurs much more rapidly than in the right ventricle, the atria, and the central and peripheral conductive system. In considering partial or complete reversibility of an ischemic stress by reperfusion and reoxygenation, three phases of global ischemia can be defined using the terminology originally applied to functional changes in the brain under global ischemia {1}:

The first phase of undisturbed function or latency period is identical with the duration of myocardial aerobic energy supply from the oxygen reserves available at the time of coronary circulatory arrest, oxyhemoglobin, oxymyoglobin, and physically dissolved oxygen, which total about 1–2 ml/ 100g left ventricular myocardium. Depending on the level of myocardial performance and O2 demand prior to ischemia, these reserves last for no more than 1–20 s under normothermic conditions.


Creatine Phosphate Global Ischemia Left Ventricular Myocardium Cardioplegic Solution Revival Time 
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© Springer Science+Business Media Dordrecht 1984

Authors and Affiliations

  • Hans Jürgen Bretschneider
  • Martha Maria Gebhard
  • Claus Jürgen Preusse

There are no affiliations available

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