Biomaterial Database

Cardiac metabolism and performance following cold potassium cardioplegia. 1978

R D Weisel, and I H Lipton, and R N Lyall, and R J Baird

Division of Cardiovascular Surgery, University of Toronto, Ontario, Canada.

The ability of cold potassium cardioplegia (CPC) to preserve cardiac metabolism and performance was evaluated in 68 patients undergoing anoxic arrest for aortocoronary bypass. Forty-five patients (group I) had a single dose of CPC inducing a mean myocardial temperature (MMT) of 32 degrees C/min. Twenty-three patients had multiple doses of CPC and systemic hypothermia to achieve a MMT of 22 degrees C/min. Arterial and coronary sinus sampling 38 minutes after aortic clamp removal permitted calculation of cardiac oxygen extraction, lactate production, CPK and CPK-MB release. Group I patients extracted less oxygen, produced more lactate, and released more CPK and CPK-MB. These indices of cardiac metabolism were found to correlate with anoxic times exceeding 30 minutes, and demonstrated more cardiac damage in group I patients at longer anoxic times. Serial measurements of cardiac output (thermodilution) and left atrial pressure during volume loading permitted construction of myocardial performance curves. Group I patients had a diminished response to volume loading postoperatively. Both the upslope and the highest stroke work attained were lower in group I and inversely related to the anoxic time. All patients made an uneventful recovery, indicating the insensitivity of clinical parameters of myocardial protection. Coronary sinus sampling and hemodynamic monitoring during volume loading permit an objective assessment of myocardial preservation.

UI	MeSH Term	Description	Entries
D007527	Isoenzymes	Structurally related forms of an enzyme. Each isoenzyme has the same mechanism and classification, but differs in its chemical, physical, or immunological characteristics.	Alloenzyme,Allozyme,Isoenzyme,Isozyme,Isozymes,Alloenzymes,Allozymes
D007773	Lactates	Salts or esters of LACTIC ACID containing the general formula CH3CHOHCOOR.
D009206	Myocardium	The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.	Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D011188	Potassium	An element in the alkali group of metals with an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the WATER-ELECTROLYTE BALANCE.
D001831	Body Temperature	The measure of the level of heat of a human or animal.	Organ Temperature,Body Temperatures,Organ Temperatures,Temperature, Body,Temperature, Organ,Temperatures, Body,Temperatures, Organ
D002315	Cardiopulmonary Bypass	Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs.	Heart-Lung Bypass,Bypass, Cardiopulmonary,Bypass, Heart-Lung,Bypasses, Cardiopulmonary,Bypasses, Heart-Lung,Cardiopulmonary Bypasses,Heart Lung Bypass,Heart-Lung Bypasses
D003402	Creatine Kinase	A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.	Creatine Phosphokinase,ADP Phosphocreatine Phosphotransferase,ATP Creatine Phosphotransferase,Macro-Creatine Kinase,Creatine Phosphotransferase, ATP,Kinase, Creatine,Macro Creatine Kinase,Phosphocreatine Phosphotransferase, ADP,Phosphokinase, Creatine,Phosphotransferase, ADP Phosphocreatine,Phosphotransferase, ATP Creatine
D006321	Heart	The hollow, muscular organ that maintains the circulation of the blood.	Hearts
D006324	Heart Arrest, Induced	A procedure to stop the contraction of MYOCARDIUM during HEART SURGERY. It is usually achieved with the use of chemicals (CARDIOPLEGIC SOLUTIONS) or cold temperature (such as chilled perfusate).	Cardiac Arrest, Induced,Cardioplegia,Induced Cardiac Arrest,Induced Heart Arrest,Cardioplegias
D006439	Hemodynamics	The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.	Hemodynamic