(Circulation. 1996;93:1556-1566.)
© 1996 American Heart Association, Inc.
Articles |
Calcium Responsiveness in Regional Myocardial Short-term Hibernation and Stunning in the In Situ Porcine Heart
Inotropic Responses to Postextrasystolic Potentiation and Intracoronary Calcium
From the Abteilung für Pathophysiologie, Zentrum für Innere Medizin des Universitätsklinikums Essen, Federal Republic of Germany.
Correspondence to Prof Dr Gerd Heusch, FESC, FACC, Abteilung für Pathophysiologie, Zentrum für Innere Medizin, Universitätsklinikum Essen, Hufelandstraße 55, 45122 Essen, Federal Republic of Germany.
Background We tested the hypothesis that decreased calcium responsiveness is responsible for the reduction in contractile function in regional hibernating and stunned myocardium in situ.
Methods and Results In 19 anesthetized swine, the
left anterior descending coronary artery flow was reduced to
decrease anterior myocardial work index (sonomicrometry) by 
60%.
During 90 minutes of hypoperfusion, creatine phosphate recovered (as
determined by biopsy specimens and bioluminescence) and no necrosis
developed (as determined by staining with triphenyl tetrazolium
chloride). In 10 swine, changes in the intracellular calcium
concentration were induced by systematic variation of the
postextrasystolic time interval at a constant
prematurity. In 9 additional swine, a graded IC calcium infusion was
performed. Under control conditions, anterior myocardial work increased
with a fully compensated postextrasystolic time
interval from 380±93 (mean±SD) to 523±98 mm Hg·mm. IC calcium
infusion increased anterior myocardial work under control conditions
from 356±85 to a maximum of 428±93 mm Hg·mm. Although the maximal
responses were decreased during postextrasystolic
potentiation (222±68 versus 523±98 mm Hg·mm) and calcium infusion
(176±32 versus 428±93 mm Hg·mm) after 90 minutes of
ischemia, the relationships between increases in anterior
myocardial work and, respectively,
postextrasystolic time interval and IC calcium were
not different. The same was true after 30 minutes of reperfusion.
Conclusions Both regional hibernating myocardium and stunned myocardium in situ are characterized by a decrease in overall myocardial calcium responsiveness; however, there appears to be no significant myocardial desensitization to calcium.
Key Words: stunning, myocardial • calcium • ischemia • contractility
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