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Calcium and stunned myocardium

¹Department of Anesthesia, St. Michael's Hospital, University of Toronto, Ontario, Canada.

Journal of Cardiac Surgery

|March 1, 1993

Summary

Calcium administration during ischemia can be harmful due to high cytosolic calcium levels. However, administering calcium during reperfusion may improve heart function recovery in stunned myocardium.

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Area of Science:

Cardiovascular Physiology
Myocardial Ischemia and Reperfusion Injury

Background:

Cytosolic calcium levels increase during ischemia and reperfusion.
Calcium administration during ischemia is generally considered detrimental.
Calcium antagonists administered before or during ischemia offer protection.

Purpose of the Study:

To investigate the role of calcium administration during reperfusion on myocardial function.
To contrast the effects of calcium administration versus calcium antagonists in myocardial ischemia/reperfusion.

Main Methods:

Administration of calcium during ischemia and reperfusion.
Administration of calcium antagonists before, during, or after ischemia/reperfusion.
Assessment of systolic and diastolic function recovery in stunned myocardium.

Main Results:

Calcium administration during ischemia is deleterious.
Calcium antagonists are protective when given before or during ischemia.
Calcium administration during reperfusion enhances recovery of systolic and diastolic function in stunned myocardium.
Calcium antagonists may not be beneficial when given after reperfusion.

Conclusions:

The timing of calcium administration is critical in myocardial ischemia/reperfusion.
While calcium antagonists are protective pre-reperfusion, calcium administration during reperfusion can be beneficial for myocardial recovery.

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