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Ann Thorac Surg 2003;76:1252-1258
© 2003 The Society of Thoracic Surgeons

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Original article: cardiovascular

Intra-myocyte ion homeostasis during ischemia-reperfusion injury: effects of pharmacologic preconditioning and controlled reperfusion

^a Department of Surgery, Birmingham, Alabama, USA
^b Department of Medicine, Birmingham, Alabama, USA
^c Department of Biostatistics, Birmingham, Alabama, USA, and Department of Pathology, Birmingham, Alabama, USA, University of Alabama at Birmingham, Birmingham, Alabama, USA

Accepted for publication April 8, 2003.

^* Address reprint requests to Dr Holman, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA.
e-mail: wholman{at}its.uab.edu

BACKGROUND: This study determines whether controlled reperfusion or diazoxide improves intramyocyte Na⁺ homeostasis using a porcine model of severe ischemia-reperfusion injury.

METHODS: Three groups (n = 10 pigs per group) had 75 minutes of left anterior descending artery occlusion during bypass. Group 1 had no treatment (control group), group 2 had controlled reperfusion (500 mL warm cardioplegia) (controlled reperfusion group), and group 3 had diazoxide (50 µmol/L before left anterior descending artery occlusion) (diazoxide group). Biopsies were taken from the left anterior descending artery region before ischemia and at 3, 5, and 10 minutes postreperfusion. Intra-myocyte Na⁺ and water contents were determined using atomic absorption spectroscopy, and Na⁺ concentrations were calculated.

RESULTS: Intra-myocyte Na⁺ increased for the diazoxide group pigs at 3-minutes postreperfusion (21.9 ± 2.9 vs 34.0 ± 3.4 µmol/mL; p = 0.02), but decreased to 19.9 ± 3.2 µmol/mL at 10 minutes postreperfusion (p = 1.0 vs baseline). At 10 minutes postreperfusion, intra-myocyte Na⁺ in the controlled reperfusion group was lower than baseline (22.3 ± 2.7 vs 17.2 ± 3.1 µmol/mL; p < 0.001). Intra-myocyte Na⁺ at 10 minutes postreperfusion for the diazoxide and controlled reperfusion groups was lower than for the control group (p < 0.05).

CONCLUSIONS: Diazoxide and controlled reperfusion improved intra-myocyte Na⁺ homeostasis after severe ischemia-reperfusion injury.

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