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Titolo:
THERE AN ALTERNATIVE TO POTASSIUM ARREST
Autore:
COHEN NM; DAMIANO RJ; WECHSLER AS;
Indirizzi:
VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,DEPT SURG,DIV CARDIOTHORAC SURG RICHMOND VA 23298
Titolo Testata:
The Annals of thoracic surgery
fascicolo: 3, volume: 60, anno: 1995,
pagine: 858 - 863
SICI:
0003-4975(1995)60:3<858:TAATPA>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
ELECTIVE CARDIAC-ARREST; REGULATED K+ CHANNELS; ADENOSINE-TRIPHOSPHATE; VENTRICULAR MYOCYTES; RAT-HEART; CRYSTALLOID CARDIOPLEGIA; MYOCARDIAL PROTECTION; POSTISCHEMIC RECOVERY; CONTRACTILE FAILURE; ACTIVATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
48
Recensione:
Indirizzi per estratti:
Citazione:
N.M. Cohen et al., "THERE AN ALTERNATIVE TO POTASSIUM ARREST", The Annals of thoracic surgery, 60(3), 1995, pp. 858-863

Abstract

Background. Mounting clinical and experimental evidence suggests thatpostoperative myocardial dysfunction is a frequent consequence of surgical global ischemia and reperfusion, despite our modern techniques of myocardial protection. The ubiquitous use of hyperkalemic depolarizing solutions in all forms of cardioplegia may be partly responsible for this phenomenon because of the known ongoing metabolic processes anddamaging transmembrane ionic fluxes that occur at depolarized membrane potentials. Cardiac arrest at hyperpolarized potentials, the naturalresting state of the heart, may avoid the shortcomings of depolarizedarrest and provide an alternative means of myocardial protection. Methods. An adenosine triphosphate-sensitive potassium channel opener, aprikalim, was used to induce hyperpolarized arrest. Aprikalim was able to produce sustained and reproducible electromechanical arrest that was reversible by reperfusion. Results. In isolated heart models, when compared with depolarized hyperkalemic arrest, hyperpolarized arrest afforded better protection from global normothermic ischemia and resulted in better postischemic recovery of function upon reperfusion. Preliminary studies in a porcine cardiopulmonary bypass model also have revealed that hyperpolarized arrest can be achieved in a model more closely approximating the clinical setting, and can effectively protect the heart during normothermic surgical global ischemia. Conclusions. Hyperpolarized cardiac arrest may offer an effective alternative to traditional potassium arrest.

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Documento generato il 01/12/20 alle ore 10:29:54