Electrode-derived myocardial pH measurements reflect intracellular myocardial metabolism assessed by phosphorus 31-nuclear magnetic resonance spectroscopy during normothermic ischemia

Axford, Trevor C.; Dearani, Joseph A.; Khait, Igor; Park, W. Michael; Patel, Maitri; Doursounian, Mheir; Neuringer, L. J.; Valeri, C. R.; Khuri, Shukri F.

doi:10.1016/s0022-5223(19)34914-1

Cited by 34 publications

(14 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second Occlusion Third Occlusion the first occlusion. Intracellular [H+] correlates very well with extracellular [H +] during the first occlusion (r values in the range between 0.88 to 0.97) 7 and follows a similar course during the periods of reperfusion and subsequent oc clusion (Fig. 4).…”

Section: First Occlusionmentioning

confidence: 59%

“…In fact, the correlation between ex tracellular pH and myocardial ATP during a 3hour occlusion is strong, yielding r values in the range of 0.85 to 0.96. 7 ATP remains depleted throughout the periods of reperfusion and sub sequent occlusions, confirming the lack of func tional viability of the myocardium as a result of…”

Section: Changes In Contractility Intracellular [H +] and High Enermentioning

confidence: 65%

“…9 In contrast to the changes in [H +] and ATP, the ^Measured by magnetic resonance spectroscopy in the open chest canine placed inside a 40-cm bore, 4.7-tesla magnet. 7 changes in PCr and inorganic phosphate (P¡) during three consecutive 20-minute occlusions are not significantly different between the oc clusions, and are completely reversed with each reperfusion (solid lines in Fig. 9).…”

Section: Changes In Intracellular [H +] and High Energy Phosphatestmentioning

confidence: 88%

See 2 more Smart Citations

Metabolic Correlates of Myocardial Stunning and the Effect of Cardiopulmonary Bypass

Khuri

Axford

García

et al. 1993

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

In order to study the metabolic consequences of myocardial stunning, repeated coronary occlusions were performed in dogs. The production of CO2, adenosine triphosphate (ATP), phosphocreatine (PCr), and inorganic phosphate (P¡) by myocardial cells was assessed, along with extracellular and intracellular pH. Our results indicate that regional coronary artery occlusion reduces the ability of the myocardium to produce H + and C0 2 and to replenish ATP post ischemia. These alterations, then, represent the hallmark of metabolic viability during periods of ischémie insult. Decreases in PCr and Pi were completely eliminated during reper fusion and, therefore, are not reflective of myocardial stunning. When normothermic cardiopulmonary bypass (CPB) is instituted and the coronary artery is occluded three times with reperfusion between each occlusion, alterations in myocardial H + and high energy phosphates are identical to those observed using only repetitive coronary occlusion. Systemic hypothermia during CPB does not protect against myocardial stunning; however, it is anticipated that inter ventions that prevent the reduction in H + and ATP levels may overcome the effects of myocardial stunning that occur during cardiac surgery. (J Card Surg 1993;8[Suppl]:262-270) Transient occlusion of a coronary artery elicits an ischémie insult resulting in contractile dys function in the myocardial segment subtended by that artery. The magnitude and reversibility of this dysfunction are determined primarily by the duration of the ischémie insult. A coronary oc clusion of less than 20 minutes duration results in prolonged regional dysfunction that, though reversible, is not promptly reversed after release of the occlusion. This prolonged but reversible regional contractile dysfunction following a brief coronary occlusion was first described by Heyndrickx et al. in 1975. . termed "myocardial stunning" by Braunwald and Kloner. 2 Because of its clinical implications, particularly in the course of revascularization by thrombolysis and angioplasty, this phenomenon has gained considerable attention among ex perimental and clinical researchers since it was first spotlighted by Braunwald and Kloner a decade ago.Brief periods of regional ischemia are often en countered in the course of cardiac surgery despite a compendium of maneuvers and techni ques devised to protect the heart against the in sults of global ischemia and reperfusion during and following the period of aortic clamping. The presence of severe coronary artery disease (and/or left ventricular hypertrophy), coupled with the heterogeneity of the distribution (and, at times, the questionable efficacy) of cardioplegic solutions, results in myocardial segments that

show abstract

Section: First Occlusionmentioning

confidence: 59%

Section: Changes In Contractility Intracellular [H +] and High Enermentioning

confidence: 65%

Section: Changes In Intracellular [H +] and High Energy Phosphatestmentioning

confidence: 88%

See 1 more Smart Citation

Metabolic Correlates of Myocardial Stunning and the Effect of Cardiopulmonary Bypass

Khuri

Axford

García

et al. 1993

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…In simple immersion preservation, the graft is in an anaerobic state and hydrogen ions are produced during myocardial ischemia by both anaerobic glycolysis and ATP hydrolysis. The intracellular pH reflects the metabolic state of myocytes during ischemia [18]. A significant depression of pHi was observed in the SI group; however, pHi levels in the CP group did not significantly decrease during preservation period.…”

Section: Discussionmentioning

confidence: 89%

“…We used 31p-NMR spectroscopy to evaluate the metabolic and functional effects of continuous coronary perfusion preservation. This technique has been used for cardiac preservation studies because it allows noninvasive, repeated measurement of the levels of myocardial high-energy phosphate stores and myocardial pH [18], which are considered to be important for graft viability. Inhibiting the catabolism of high-energy phosphates plays an important role in myocardium preservation, and may prevent the induction of irreversible damage during ischemia [19].…”

Section: Discussionmentioning

confidence: 99%

The effect of coronary perfusion with an oxygenated celsior solution on 12-hour cardiac preservation

Tsutsumi¹,

Izumi²,

Oshima³

et al. 2001

Int J Angiol

View full text Add to dashboard Cite

Cardiac Transplantation Following a 24-h Preservation Using a Perfusion Apparatus

Tsutsumi¹,

Oshima²,

Mohara³

et al. 2001

Journal of Surgical Research

View full text Add to dashboard Cite

Electrode-derived myocardial pH measurements reflect intracellular myocardial metabolism assessed by phosphorus 31-nuclear magnetic resonance spectroscopy during normothermic ischemia

Cited by 34 publications

References 7 publications

Metabolic Correlates of Myocardial Stunning and the Effect of Cardiopulmonary Bypass

Metabolic Correlates of Myocardial Stunning and the Effect of Cardiopulmonary Bypass

The effect of coronary perfusion with an oxygenated celsior solution on 12-hour cardiac preservation

Cardiac Transplantation Following a 24-h Preservation Using a Perfusion Apparatus

Contact Info

Product

Resources

About