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Ann Thorac Surg 2000;70:633-638
© 2000 The Society of Thoracic Surgeons

Original articles: cardiovascular

Mechanisms responsible for cell volume regulation during hyperkalemic cardioplegic arrest

Xiwu Sun, MD, PhDa, Christopher T. Ducko, MDa, Eric M. Hoenicke, MDa, Karen Reiglea, Ralph J. Damiano, Jr, MDa

a Division of Cardiothoracic and Vascular Surgery, The Milton S. Hershey Medical Center, Penn State University, Hershey, Pennsylvania, USA

Address reprint requests to Dr Damiano, Division of Cardiothoracic Surgery, The Washington University School of Medicine, Queeny Tower, Suite 3108, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110-1013
e-mail: damianor{at}msnotes.wustl.edu

Background. Cardioplegia has been shown to induce significant cell swelling. This study tested the hypothesis that (1) the [K+][Cl-] product of the cardioplegia solution is the main determinant of myocyte swelling, and (2) reperfusion myocyte shrinkage results from a rectifying Cl- conductance.

Methods. Rabbit ventricular myocytes were superfused with 37°C Krebs-Henseleit solution for 10 minutes. Then cells underwent 20 minutes of superfusion with standard St. Thomas’ solution ([K+][Cl-] product = 2566 mmol/L2) and two solutions with lower [K+][Cl-] product (1500 and 700 mmol/L2) at 9°C. Cells were then resuperfused with 37°C Krebs-Henseleit solution for 30 minutes. Cell volume was measured by videomicroscopy.

Results. Cells superfused with St. Thomas’ having [K+][Cl-] products of 2,566, 1,500, and 700 mmol/L2 swelled by 9.18% ± 3.57%, 5.51% ± 1.08%, and 1.49% ± 1.56%, respectively. Reexposure to Krebs-Henseleit solution caused these cells to shrink by 5.79% ± 1.41%, 8.72% ± 3.68%, and 13.46% ± 5.60%, respectively. This shrinkage was blocked by Cl- channel blockers given at the onset of superfusion.

Conclusions. Lowering the [K+][Cl-] product of St. Thomas’ solution attenuated myocyte edema. Myocyte shrinkage during reexposure to Krebs-Henseleit solution resulted from the volume-activated Cl- channel.




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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]


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