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The Annals of Thoracic Surgery, Vol 51, 89-93, Copyright © 1991 by The Society of Thoracic Surgeons
PS Mankad, AH Chester and MH Yacoub
We studied the effect of potassium concentration in cardioplegic solutions
on endothelial function by examining its influence on 5- hydroxytryptamine-
(5-HT) and nitroglycerin-induced vasodilation in the isolated rat heart.
Forty-eight rat hearts were perfused on a modified Langendorff preparation.
After a baseline record of increase in coronary flow induced by 10(-7) M
5-HT and 10 micrograms/mL nitroglycerin, the hearts were perfused for 30 or
60 minutes with either St. Thomas' solution or Bretschneider solution
containing 20 mmol/L of potassium or for 30 minutes with either solution
containing 30 mmol/L of potassium (n = 8 in each). Initially, 5-HT and
nitroglycerin caused a 39.0% +/- 3.3% and 39.7% +/- 2.8% increase in
coronary flow, respectively. After 30 or 60 minutes' perfusion with St.
Thomas' solution containing 20 mmol/L of potassium, there was little change
in the response to 5-HT or nitroglycerin (5-HT, 43.1% +/- 4.1%;
nitroglycerin, 38% +/- 3.2%). Similarly, perfusion with Bretschneider
solution (20 mmol/L K+) for 30 or 60 minutes did not alter the degree of
vasodilation (5-HT, 39.2% +/- 2.9%; nitroglycerin, 38.0% +/- 3.3%).
However, perfusion with St. Thomas' solution containing 30 mmol/L of
potassium for 30 minutes abolished the endothelial-dependent 5-HT- induced
vasodilation (5-HT, -1.6% +/- 1.4%; nitroglycerin, 36.9% +/- 2.2%).
Perfusion with Bretschneider solution (30 mmol/L K+) gave similar results
(5-HT, -2.1% +/- 1.2%; nitroglycerin, 36.4% +/- 1.7%). We conclude that the
concentration of potassium in cardioplegic solutions plays a critical role
in causing functional endothelial damage.
ARTICLES
Role of potassium concentration in cardioplegic solutions in mediating endothelial damage
National Heart and Lung Institute, London, United Kingdom.
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