Magnesium ion is beneficial in hypothermic crystalloid cardioplegia

Ann Thorac Surg. 1991 Mar;51(3):359-66; discussion 367. doi: 10.1016/0003-4975(91)90845-h.

Abstract

The role of magnesium ion and its relation to the calcium concentration of cardioplegic solutions was reexamined in this study. Isolated rat hearts were used with an oxygenated modified Krebs-Henseleit bicarbonate buffer as perfusion medium. The hearts were arrested for 20 minutes at 37 degrees C or 90 minutes at 24 degrees C. Treatment groups received one dose of nine possible cardioplegic solutions containing magnesium (0, 1.2, or 15 mmol/L) and calcium (0.05, 1.5, or 4.5 mmol/L). Ninety-six percent of the 75 magnesium-treated hearts recovered, regardless of the calcium concentration, in contrast to a 52% recovery rate in the 69 hearts that did not receive magnesium. The addition of 15 mmol/L Mg2+ to a cardioplegic solution containing no magnesium but 0.05 mmol/L Ca2+ significantly increased (p less than 0.01) the percent recovery of the following parameters of cardiac function: systolic pressure, 74% to 93% (37 degrees C), 64% to 98% (24 degrees C); cardiac output, 76% to 101% (37 degrees C), 71% to 102% (24 degrees C); stroke work, 64% to 104% (37 degrees C), 52% to 99% (24 degrees C); and adenosine triphosphate level, 75% to 83% (37 degrees C), 58% to 90% (24 degrees C). There were significant reductions (p less than 0.03) in percent recovery (37 degrees C and 24 degrees C) of cardiac output, stroke work, and adenosine triphosphate level in the groups that contained 0 or 15 mmol/L Mg2+ as the calcium concentration was increased from 0.05 to 4.5 mmol/L.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Adenosine Triphosphate / metabolism
  • Animals
  • Calcium / pharmacology
  • Cardioplegic Solutions / pharmacokinetics
  • Cardioplegic Solutions / pharmacology*
  • Dose-Response Relationship, Drug
  • Heart / drug effects*
  • Heart Arrest, Induced / methods*
  • Hemodynamics / drug effects
  • Humans
  • Hydrogen-Ion Concentration
  • Hypothermia, Induced
  • In Vitro Techniques
  • Magnesium / pharmacology*
  • Male
  • Rats
  • Rats, Inbred Strains

Substances

  • Cardioplegic Solutions
  • Adenosine Triphosphate
  • Magnesium
  • Calcium