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Thorac Cardiovasc Surg 2002; 50(4): 208-215
DOI: 10.1055/s-2002-33091
Original Cardiovascular
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Initial Reperfusion with Magnesium after Cardioplegic Arrest Attenuates Myocardial Reperfusion Injury[*]

F.  Fuchs1 , K.  Messmer1 , H.  Kuppe2 , H.  Habazettl3
  • 1Institute for Surgical Research, Ludwig-Maximilians-Universität München, Germany
  • 2Institute of Anesthesiology, Deutsches Herzzentrum Berlin, Germany
  • 3Department of Physiology, Freie Universität Berlin, Germany
The results from this study were presented in part at the Chirurgische Forschungstage 2000, Marburg, Germany, and at the Annual Meeting of the American Society of Anesthesiologists 2001, New Orleans, USA
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Publication History

Publication Date:
07 August 2002 (online)

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Abstract

Background: Magnesium's effect on calcium ion concentrations may attenuate myocardial reperfusion injury. The aim of this study was therefore to investigate the effects on the recovery of myocardial function of initial reperfusion with varying Mg2+ concentrations following cardioplegic arrest. Methods: Isolated guinea pig hearts underwent 3.5 hours of cardioplegic arrest in St. Thomas Hospital II solution (STH) or Bretschneider HTK solution (HTK) at 24° C. Control hearts were reperfused with normal Krebs-Henseleit solution (KHS). In the therapy groups, hearts were initially reperfused with 5, 10, or 20 mM Mg2+ for 15 minutes, followed by 30 minutes of perfusion with KHS. Results: During initial reperfusion, elevated Mg2+ concentrations markedly reduced rate-pressure product, dP/dt and O2 demand. Release of LDH and CK was reduced in the therapy groups pretreated with Bretschneider HTK. After Mg2+ washout, left ventricular function recovery and compliance was improved after HTK but not after STH cardioplegia. Following both STH and HTK cardioplegia, Mg2+ reperfusion reduced reperfusion arrhythmias. Conclusions: The combination of HTK cardioplegia with 15 min initial Mg2+ (5 and 10 mM, but not 20 mM) reperfusion was clearly superior to HTK followed by immediate Krebs-Henseleit reperfusion as well as STH cardioplegia with or without initial Mg2+ reperfusion. The high Mg2+ concentrations in the STH solution might mask beneficial effects of Mg2+ reperfusion.

Key words

Magnesium - Calcium - Reperfusion injury - Cardioplegic solutions

1 The results from this study were presented in part at the Chirurgische Forschungstage 2000, Marburg, Germany, and at the Annual Meeting of the American Society of Anesthesiologists 2001, New Orleans, USA

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1 The results from this study were presented in part at the Chirurgische Forschungstage 2000, Marburg, Germany, and at the Annual Meeting of the American Society of Anesthesiologists 2001, New Orleans, USA

Helmut Habazettl

Department of Physiology, Freie Universität Berlin

Arnimallee 22

14195 Berlin

Germany

Phone: +49 (30) 8445-1638

Fax: +49 (30) 8445-1634

Email: habazett@zedat.fu-berlin.de