Prolonged diuretic administration and myocardial tolerance to ischaemia

Hearts from rats, which received high doses of furosemide alone or the same doses of furosemide plus amiloride in a diet with low magnesium content for 4 weeks, were isolated and perfused in the Langendorff mode. After 15 min. of normoxic control perfusion no differences were found between the two groups of hearts with respect to cardiac physiology. After 20 min. of subtotal, global ischaemia and 15 min. of reperfusion the furosemide plus amiloride hearts showed a significantly higher recovery of function (judged by pressure rate product and coronary flow rate) than furosemide hearts. However, the myocardial content of adenosine triphosphate, creatine phosphate, and electrolytes at the end of the experiment exhibited no difference between the two groups. In separate experiments it was found that the addition of amiloride to the furosemide regimen significantly raised and almost normalized the values of plasma magnesium and potassium. Myocardial calcium was lower, whereas the magnesium and potassium content in the hearts was not different from the furosemide group. It is concluded that the administration of amiloride to rats provided high doses of furosemide and marginal magnesium supplies afforded some protection upon the ischaemic heart.