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Ann Thorac Surg 1992;54:301-305
© 1992 The Society of Thoracic Surgeons

Articles

Acute severe postischemic myocardial depression reversed by triiodothyronine

Fred W. Holland, II, MD, Paul S. Brown, Jr, MD, Richard E. Clark, MD*

Surgery Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland USA

Accepted for publication January 10, 1992.

* Address reprint requests to Dr Clark, Cardiovascular and Pulmonary Research Center, Allegheny-Singer Research Institute, 320 E North Ave, Pittsburgh, PA 15212.

The purpose of this study was to determine the effects of triiodothyronine (T3) on postischemic left ventricular performance and high-energy phosphate content in a severe injury model. Isolated working rat hearts (n = 63) received 20 mL of hyperkalemic NIH No. 1 cardioplegia and were subjected to 20 minutes of ischemia at 37 °C. Treated hearts were reperfused with T3-supplemented modified Krebs-Henseleit buffer. Control hearts did not receive T3 supplementation. All treated hearts (n = 44) performed work after ischemia, whereas 26% ([equation]) of the control hearts were not able to perform any left ventricular work after ischemia. Comparisons with preischemic values demonstrated significant progressive hemodynamic recovery with increasing concentrations of T3 (0, 0.06, 0.15, and 0.60 ng/mL) with concomitant recovery of left ventricular stroke work index (63%, 72%, 89% [p < 0.051], and 99% [p < 0.05], respectively). There were corresponding increases in recovery of aortic flow, systolic pressure, cardiac index, and stroke volume index (p < 0.05). There were no significant changes in coronary sinus flow or heart rate in any group compared with preischemic values. Comparisons of postischemic high-energy phosphate concentrations also demonstrated no change between treated and untreated groups (p > 0.05). We conclude that administration of T3 in a severe left ventricular injury model significantly augments rapid ventricular recovery with no change in postischemic high-energy phosphate concentrations.




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