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Related Experiment Videos

Postischemic [Ca2+] repletion improves cardiac performance without altering oxygen demands.

H Yokoyama1, J S Julian, J Vinten-Johansen

  • 1Department of Cardiothoracic Surgery, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.

The Annals of Thoracic Surgery
|June 1, 1990
PubMed
Summary
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Normalizing blood calcium levels after heart surgery improves left ventricular function and stiffness without increasing oxygen demand. This correction of hypocalcemia aids recovery from ischemia and reperfusion injury.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Physiology

Background:

  • Postischemic hypocalcemia can impair left ventricular function.
  • Reperfusion injury, particularly calcium overload, may counteract the benefits of calcium correction.

Purpose of the Study:

  • To evaluate the effect of normalizing blood calcium concentration on postischemic left ventricular mechanics.
  • To assess the impact of calcium correction on myocardial oxygen consumption and chamber stiffness.

Main Methods:

  • Open-chest dogs on cardiopulmonary bypass underwent global ischemia followed by hypothermic, hypocalcemic blood cardioplegia.
  • Left ventricular systolic and diastolic mechanics were assessed using pressure-diameter relations and oxygen consumption.
  • Systemic calcium concentration was measured before and after correction.

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Main Results:

  • Systemic calcium concentration decreased significantly after hypocalcemic reperfusion.
  • Left ventricular inotropic state, depressed post-ischemia, was restored to baseline with calcium correction.
  • Chamber stiffness increased significantly after hypocalcemic reperfusion but decreased with calcium correction.
  • Myocardial oxygen consumption remained unchanged after calcium correction.

Conclusions:

  • Normalizing blood calcium concentration after blood cardioplegia improves postischemic left ventricular performance.
  • Calcium correction enhances ventricular compliance and function without increasing myocardial oxygen consumption.
  • This strategy mitigates adverse effects of hypocalcemia and potential reperfusion injury.