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J Thorac Cardiovasc Surg 1999;118:173-180
© 1999 Mosby, Inc.
CARDIOPULMONARY SUPPORT AND PHYSIOLOGY |
From the Cardiovascular Research Laboratory, Grantham Hospital, and Division of Cardiothoracic Surgery, Department of Surgery, University of Hong Kong, Aberdeen, Hong Kong.
Supported in part by Hong Kong Research Grants Council grant (HKU7280/97M), the University of Hong Kong Committee of Research and Conference Grants (337/048/0018, 335/048/0079), and the University of Hong Kong Grants (014/048/9602, 344/048/0001).
Address for reprints: Professor Guo-Wei He, MD, PhD, Chair of Cardiothoracic Surgery, University of Hong Kong, Grantham Hospital, 125 Wong Chuk Hang Rd, Aberdeen, Hong Kong.
Objectives: We examined the effect of St Thomas' Hospital solution on endothelium-derived hyperpolarizing factormediated function in the porcine coronary microarteries with emphasis on the effect of temperature and washout time.
Methods: Microartery rings (diameter, 200-450 µm) were studied in myograph. The arteries were incubated in St Thomas Hospital or Krebs solution (control) at 4°C for 4 hours followed by 45 minutes (group Ia) or 90 minutes washout (group Ib) or at 22°C for 1 hour followed by 45 minutes (group IIa) or 90 minutes washout (group IIb) and precontracted with 8.5 log M U 46619. The endothelium-derived hyperpolarizing factormediated relaxation to bradykinin was studied when endothelium-derived nitric oxide and prostaglandin I2 were inhibited with the presence of 7 µmol/L indomethacin and 300 µmol/L NG-nitro-L -arginine.
Results: After exposure to St Thomas Hospital solution, the maximal endothelium-derived hyperpolarizing factormediated relaxation (percentage of the precontraction) was significantly reduced at either temperature after washout for 45 minutes (group Ia, 42.7% ± 3.5% vs 69.0% ± 5.3%; n = 9; P = .000; and group IIa, 12.3% ± 1.6% vs 56.1% ± 4.4%; n = 8; P = .000) but fully recovered after washout for 90 minutes. The U46619-induced contraction force was also significantly reduced after washout for 45 minutes (P < .001) but fully recovered at 90 minutes.
Conclusions: Under profound and moderate hypothermia, St Thomas' Hospital solution impairs endothelium-derived hyperpolarizing factormediated relaxation and smooth muscle contraction in the coronary microarteries. These effects exist during the reperfusion period for at least 45 minutes after exposure to St Thomas' Hospital solution and may account for the possible myocardial dysfunction during reperfusion.
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