HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ralph J. Damiano, Jr. Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shaffer, R. F. Articles by Damiano, R. J. Search for Related Content PubMed PubMed Citation Articles by Shaffer, R. F. Articles by Damiano, R. J., Jr.

J Thorac Cardiovasc Surg 1998;115:1189-1193
© 1998 Mosby, Inc.

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

Prevention of cellular edema directly caused by hypothermic cardioplegia: Studies in isolated human and rabbit atrial myocytes

Supported by National Institutes of Health grants HL-46764 and HL-51032.

Received for publication April 10, 1997. Revisions requested May 14, 1997; revisions received Dec. 10, 1997. Accepted for publication Dec. 22, 1997. Address for reprints: Ralph J. Damiano, Jr., MD, Division of Cardiothoracic Surgery, Pennsylvania State University, P.O. Box 850, Hershey, PA 17033-0850.

Objectives: This study tested the hypothesis that edema during hypothermic cardioplegia is caused by the hypotonicity of the perfusate at cold temperatures. Methods: The volume of isolated human and rabbit atrial myocytes was measured by video microscopy under nonischemic conditions. Each cell served as its own control. Results: After equilibration in 37° C physiologic buffer (Tyrode's solution), exposure to 9° C St. Thomas' Hospital solution for 20 minutes caused human atrial cells to swell by 20% and rabbit atrial cells to swell by 10%. Cell volume fully recovered on rewarming in 37° C physiologic solution. Cell swelling was due to the composition of St. Thomas' Hospital solution rather than hypothermia alone. Exposure to 9° C physiologic solution did not significantly affect cell volume. Swelling of myocytes was largely prevented by replacing most of the Cl in St. Thomas' Hospital solution with an impermeant anion so that the product of the concentrations of K and Cl were the same as in the physiologic solution. Conclusions: This study suggests that cell swelling during hypothermic cardioplegia is caused in part by the composition of the cardioplegic solution. The volume of cardiac myocytes appears to follow a Donnan equilibrium in the cold, and the perfusate KCl product determines water movement. Thus, the tonicity of hyperkalemic cardioplegic solutions can be adjusted to a physiologic value by replacing most Cl by an impermeant anion. Following this simple principle, a reformulation of cardioplegic solutions may be able to minimize iatrogenic myocardial edema.

This article has been cited by other articles:

				C. M. Baumgarten Cell Volume Regulation in Cardiac Myocytes: A Leaky Boat Gets a New Bilge Pump J. Gen. Physiol., November 1, 2006; 128(5): 487 - 489. [Full Text] [PDF]

				S. M. Prasad, A. S. Al-Dadah, G. D. Byrd, T. P. Flagg, J. Gomes, R. J. Damiano Jr, C. G. Nichols, and J. S. Lawton Role of the Sarcolemmal Adenosine Triphosphate-Sensitive Potassium Channel in Hyperkalemic Cardioplegia-Induced Myocyte Swelling and Reduced Contractility Ann. Thorac. Surg., January 1, 2006; 81(1): 148 - 153. [Abstract] [Full Text] [PDF]

				S. Mizutani, A. S. Al-Dadah, J. B. Bloch, S. M. Prasad, M. D. Diodato, R. B. Schuessler, R. J. Damiano Jr, and J. S. Lawton Hyperkalemic Cardioplegia-Induced Myocyte Swelling and Contractile Dysfunction: Prevention by Diazoxide Ann. Thorac. Surg., January 1, 2006; 81(1): 154 - 159. [Abstract] [Full Text] [PDF]

				S. Mizutani, S. M. Prasad, A. D. Sellitto, R. B. Schuessler, R. J. Damiano Jr, and J. S. Lawton Myocyte Volume and Function in Response to Osmotic Stress: Observations in the Presence of an Adenosine Triphosphate-Sensitive Potassium Channel Opener Circulation, August 30, 2005; 112(9_suppl): I-219 - I-223. [Abstract] [Full Text] [PDF]

				X. Sun, C. T. Ducko, E. M. Hoenicke, K. Reigle, and R. J. Damiano Jr Mechanisms responsible for cell volume regulation during hyperkalemic cardioplegic arrest Ann. Thorac. Surg., August 1, 2000; 70(2): 633 - 638. [Abstract] [Full Text] [PDF]

				E. R. Stephenson Jr, A. M. Jayawant, C. M. Baumgarten, and R. J. Damiano Jr Cardioplegia-induced cell swelling: prevention by normothermic infusion Ann. Thorac. Surg., May 1, 2000; 69(5): 1393 - 1398. [Abstract] [Full Text] [PDF]

				J. S. Danetz, R. D. Davies, H. F. Clemo, and C. M. Baumgarten RABBIT VENTRICULAR MYOCYTE VOLUME CHANGES AS A DIRECT RESULT OF CRYSTALLOID CARDIOPLEGIA IN CONGESTIVE HEART FAILURE INDUCED BY AORTIC REGURGITATION J. Thorac. Cardiovasc. Surg., April 1, 2000; 119(4): 826 - 833. [Abstract] [Full Text] [PDF]

				J. S. Danetz, H. F. Clemo, R. D. Davies, R. P. Embrey, R. J. Damiano Jr, and C. M. Baumgarten AGE-RELATED EFFECTS OF ST THOMAS’ HOSPITAL CARDIOPLEGIC SOLUTION ON ISOLATED CARDIOMYOCYTE CELL VOLUME J. Thorac. Cardiovasc. Surg., September 1, 1999; 118(3): 467 - 476. [Abstract] [Full Text] [PDF]

				A. M. Jayawant, E. R. Stephenson Jr., C. M. Baumgarten, and R. J. Damiano Jr. Prevention of cell swelling with low chloride St. Thomas'Hospital solution improves postischemic myocardial recovery J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1196 - 1202. [Abstract] [Full Text] [PDF]