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R Deslauriers

Publications and source records attributed to R Deslauriers.

At least 19 recordsLinked to original sources

Effects of regional hypoxia and acidosis on Rb(+) uptake and energetics in isolated pig hearts: (87)Rb MRI and (31)P MR spectroscopic study.

The study compared the effects of regional hypoxia and acidosis on Rb(+) uptake and energetics in isolated pig hearts perfused by the Langendorff method. The left anterior descending artery (LAD) was cannulated and the LAD bed was perfused with the same specific flow as the whole heart. Following equilibration with normal Krebs-Henseleit buffer (KHB, pO(2) 568 mm Hg, pH 7.42) the perfusate was switched to one that contained Rb(+) (Rb-KHB). Simultaneously, perfusion through the LAD was carried out with hypoxic (pO(2)=31 mm Hg), an acidemic (pH 7.12) or normal (pO(2)=550 mm Hg) Rb-KHB for 120 min. (87)Rb images of the entire heart or localized (31)P spectra from the left ventricular anterior wall were acquired. Hypoxia decreased the maximal (87)Rb image intensity and Rb(+) flux in the anterior wall to 79+/-9% and 85+/-7%, respectively, of that in the posterior wall. Extracellular acidosis did not affect (87)Rb image intensity and reduced Rb(+) flux (83+/-10%). During hypoxia phosphocreatine and ATP decreased to 36+/-10 and 50+/-15% of baseline, respectively and intracellular pH (pHi) decreased to 6.90+/-0.05. Extracellular acidosis did not affect the phosphocreatine or ATP levels but reduced pHi (7.06+/-0.18 vs. 7.26+/-0.06 in control). We suggest that intracellular acidosis plays a role in the inhibition of Rb(+) uptake during hypoxia.

Acidosis↗

Simultaneous antegrade/retrograde cardioplegia protects myocardium distal to a coronary occlusion: a study in isolated pig hearts.

This study was designed to assess the effects of simultaneous antegrade/retrograde cardioplegia (SARC) on myocardial perfusion and energy metabolism in the region supported by the occluded left anterior descending artery (LAD) in isolated pig hearts. It was found that injection of Gd-DTPA into the aorta during antegrade cardioplegia (AC) did not result in signal increase in the LAD region on T(1)-weighted images. During SARC, however, Gd-DTPA was detected in the LAD region with the contrast agent injected into the aorta and the coronary sinus (CS), respectively. This suggests that SARC delivered blood cardioplegia to the jeopardized myocardium through both arterial and venous perfusion routes. Moreover, localized (31)P spectra showed that occlusion of the LAD during AC resulted in severe ischemic changes in the LAD myocardium and the abnormal metabolic changes were completely abolished by use of SARC. Finally, recovery of myocardial contractile function during reperfusion in the hearts subjected to SARC was significantly better compared to those arrested with AC alone. It was concluded that the myocardium distal to a coronary occlusion can be fully protected by use of SARC.

Animals↗

Effects of flow and energy metabolism on injury and Rb(+) uptake in pig hearts: an (87)Rb and (31)P NMR study.

In this work the roles of coronary flow (CF) and metabolism in Rb(+) (K(+) congener) uptake were studied. In isolated pig hearts the left anterior descending artery (LAD) was cannulated to maintain adequate perfusion of the LAD bed. Rb(+) loading was initiated and the LAD flow was either completely stopped (no flow (NF)) or reduced to 12% (low flow (LF)), or buffer was deoxygenated without change in flow (hypoxic flow (HYP)) for 2 h. CF through the LAD was then restored to normal, or perfusion was switched to oxygenated buffer. Serial (87)Rb MR images or localized (31)P spectra were acquired to compare the Rb(+) uptake and energetics in the left ventricular (LV) anterior (ischemic/hypoxic) and posterior (normal) walls. End-ischemic/hypoxic (87)Rb signal intensities in the anterior wall were higher and the fluxes were greater in the HYP and LF groups than in the NF group. Phosphocreatine and ATP decreased less significantly and recovered better in the HYP and LF groups. Upon reperfusion/reoxygenation, the HYP and LF groups showed higher (87)Rb signal intensities and smaller or no infarctions in the anterior wall compared to those in the NF group. Ischemia reduces Rb(+) uptake due to both flow limitations and metabolic inhibition of cellular transport. (87)Rb MRI has a potential for distinguishing necrotic and reversibly damaged tissue.

Animals↗

Is deep hypothermia necessary for unilateral antegrade cerebral perfusion during circulatory arrest? A magnetic resonance study in a pig model.

OBJECTIVE: Localized (31)P magnetic resonance spectroscopy (MRS) was used to investigate whether unilateral antegrade cerebral perfusion (U-ACP) could maintain normal energy metabolism and intracellular pH (pHi) in both hemispheres of the brain during deep (15 degrees C) and moderate (28 degrees C) hypothermic circulatory arrest (HCA). METHODS: Eleven pigs were exposed to 120 min of U-ACP during HCA at 15 degrees C (group I, n=6) or 28 degrees C (group II, n=5), followed by 60 min of cardiopulmonary bypass (CPB) at 37 degrees C. Localized (31)P MR spectra were acquired every 30 min. Histopathology was performed at the completion of each experiment. RESULTS: MR recorded no changes in energy metabolites (phosphocreatine and ATP), or pHi during U-ACP in either group, and no significant differences were found in any of the energy metabolites or pHi between the left and right hemispheres. Histopathology showed no significant morphological changes in the neurons. CONCLUSIONS: During either deep or moderate HCA, unilateral ACP through the right axillary artery prevents ischemic events in both hemispheres of normal pig brains. Deep hypothermia may not be necessary when using U-ACP.

Animals↗

Effect on myocardial perfusion of simultaneous delivery of cardioplegic solution through a single coronary artery and the coronary sinus.

OBJECTIVE: This study was to determine whether simultaneous antegrade-retrograde cardioplegia through a single coronary artery and the coronary sinus provides sufficient and homogeneous perfusion to the heart. METHODS: Simultaneous antegrade-retrograde cardioplegia was conducted in 7 isolated pig hearts through the coronary sinus in conjunction with the left anterior descending artery, the left circumflex artery, and the right coronary artery, respectively. The efficacy of simultaneous antegrade-retrograde cardioplegia for myocardial perfusion was assessed by monitoring the distribution of magnetic resonance contrast agent and measuring the effluent from the venting coronary arteries. RESULTS: Injection of contrast agent into a perfusing artery during simultaneous antegrade-retrograde cardioplegia resulted in increased image signal intensity not only in the territory of the perfusing artery but also in the areas normally served by the other 2 venting arteries (including the right ventricular wall). The myocardium in the territories of the 2 venting arteries was lightened with contrast agent given into the coronary sinus during simultaneous antegrade-retrograde cardioplegia. Myocardium in the perfusing artery territory and right ventricular wall remained dark. Moreover, a significant amount of effluent was collected from the venting arteries during simultaneous antegrade-retrograde cardioplegia: 4.7 to 7.8 mL/min from the right coronary artery; 10.5 to 17.7 mL/min from the left anterior descending artery; and 9.7 to 15.2 mL/min from the left circumflex coronary artery. CONCLUSIONS: Simultaneous antegrade-retrograde cardioplegia through a single coronary artery and the coronary sinus provides homogeneous perfusion to the entire heart. During simultaneous antegrade-retrograde cardioplegia, arterial flow supports its own designated myocardium, as well as adjacent myocardium normally served by the venting arteries; the arterial route also supports the right ventricular free wall when the right coronary artery is vented. Venous perfusion of simultaneous antegrade-retrograde cardioplegia mainly supports myocardium in the territories of the venting arteries and does not perfuse the right ventricular free wall. Blood flow delivered to myocardium normally supported by the venting arteries is believed to be sufficient to prevent ischemic injury.

Animals↗

Contrast agent distribution in microvascular damage of infarcted pig myocardium.

PURPOSE: We determined whether reperfusion damage was sufficient to allow extravasation of a large molecular weight contrast agent into infarcted pig myocardium. MATERIAL AND METHODS: Five pig hearts were subjected to in situ occlusion of the left anterior descending coronary artery (2 h) followed by reperfusion (1 h). The hearts were excised and perfused in the Langendorff mode for ex vivo MR imaging. Polylysine-Gd-DTPA (50,000 Da) and Gd-DTPA (500-700 Da) were injected into the aorta (alternately) and followed by measurements of T1 relaxation and mean transit time (MTT). RESULTS: In the normal myocardium, MTT of Gd-DTPA (56.8+/-23.2 s) was significantly (p=0.02) longer than that of polylysine-Gd-DTPA (29.0+/-7 s). However, both normal and infarcted myocardium showed similar MTT (29.0+/-7.0 vs. 28.0+/-5.0 s, p>0.05) when using polylysine-Gd-DTPA. CONCLUSION: The results indicate that the permeability of capillaries to polylysine-Gd-DTPA was not significantly higher in infarcted regions of the myocardium compared to normal tissue. However, infarcted myocardium displayed an increased permeability to the small molecular weight Gd-DTPA. We conclude that microvascular damage may not be sufficient to allow the extravasation of polylysine-Gd-DTPA in infarcted myocardium.

Animals↗

Three-dimensional (87)Rb NMR imaging and spectroscopy of K(+) fluxes in normal and postischemic pig hearts.

K(+) uptake rates were measured in the anterior (An) and posterior (Pos) LV walls of pig hearts before and after regional ischemia and reperfusion using Rb(+) as a K(+) congener and 3D (87)Rb NMR imaging and spectroscopy as detection methods. The hearts were perfused by the Langendorff method with Krebs-Henseleit (KH) buffer and loaded with Rb(+) (4.7 mM, Rb-KH) after 120-min ischemia and 60-min reperfusion. A second protocol involved Rb(+) loading prior to ischemia. Ischemia was produced by occlusion of the left anterior descending artery, which after 110 min of reperfusion resulted in infarction in the An wall (24 +/- 6% of the LV mass) determined by triphenyltetrazolium chloride staining. At the end of reperfusion pressure-rate product and oxygen consumption rate decreased to 58 +/- 10 and 74 +/- 4% of their preischemic values, respectively. Phosphocreatine, ATP, and intracellular pH (pHi), measured by (31)P NMR spectroscopy in the infarcted area, decreased to 59 +/- 17, 32 +/- 6%, and 6.7 +/- 0.36 (from 7.05 +/- 0.13), respectively. Serial (87)Rb images were acquired according to both protocols. Rate constants (k x 10(3), min(-1)), relative amount of intracellular Rb(+) (A, %) and relative fluxes (F = kA, %/min) for the An and Pos walls were determined from the images. Before ischemia, F and k were comparable in the Pos and An walls. Ischemia + reperfusion decreased F in the An wall (from 4.4 +/- 0.3 to 1.4 +/- 0.85) due to a decrease in A (20 vs. 73) and increased F in Pos wall (from 3.2 +/- 0.6 to 6.6 +/- 0.23) due to an increase in k (from 42 +/- 3 to 93 +/- 6). The intensities of the Rb images correlated with the Rb(+) content measured in tissue samples. Magn Reson Med 44:83-91, 2000. Published 2000 Wiley-Liss, Inc.

Analysis of Variance↗

Effects of ischemia on intracellular rubidium in pig and rat hearts: (87)Rb NMR imaging and spectroscopic study.

87Rb MR imaging and spectroscopy were used to study the effects of ischemia on the properties of K(+) in cardiac tissue. Isolated pig and rat hearts perfused by the Langendorff method with Krebs-Henseleit buffer were preloaded with Rb(+). Ischemia (Isc) was induced by 120-min occlusion of the left anterior descending artery in the pig hearts or by stopping perfusion for 33 min in the rat hearts. Serial (87)Rb MR images or spectra from the anterior (An) LV wall of pig hearts were acquired continuously. The intensities of the Rb images of the An and posterior (Pos) walls were similar and stable during the first 45 min of ischemia. The intensity of signal from the An wall (Isc) then gradually increased by 60 +/- 8% relative to the preischemic value (vs. 31 +/- 5% increase in Pos wall) and necrosis (19 +/- 5% of the LV wall mass) developed upon reperfusion. The Rb(+) content was lower in the ischemic (An) than in the normal (Pos) area (22.3 +/- 3 vs. 28.4 +/- 1.3 mmol/g wet wt). A similar pattern was observed in the peak heights of (87)Rb spectra from the An wall, which increased by 40 +/- 16% (vs. 21 +/- 11% in control) due to a 12% decrease in the apparent Rb linewidth (LW) and a 24 +/- 14% increase in the peak area. The Rb peak comprised narrow (297 +/- 21 Hz) and broad (1098 +/- 40 Hz, 59 +/- 3% of total area) Lorentzian components. The LW of the broad component decreased by 14%, while the narrow component did not change markedly. In the rat hearts ischemia caused a 33 +/- 4% increase in the (87)Rb peak height as a result of peak narrowing (13 +/- 1%), and an increase in peak area (17 +/- 5%). The decreases in LW and increases in Rb(+) visibility can be explained by an increase in Rb(+) mobility caused by displacement of Rb(+) from anionic binding sites by H(+) (ischemic acidosis) and changes in intracellular compartmentalization of Rb(+). Magn Reson Med 44:193-200, 2000.

Analysis of Variance↗

Noninvasive assessment of cardiac ischemic injury using (87)Rb and (23)Na MR imaging, (31)P MR, and optical spectroscopy.

The aim of the study was to compare and analyze different noninvasive indices of cell damage in the isolated pig heart model of regional ischemia. We used (23)Na and (87)Rb MR imaging to evaluate Na(+)/K(+) balance, (31)P MR spectroscopy to measure energetics, and optical spectroscopy to assess oxymyoglobin (MbO(2)). Hearts were subjected to 120-min occlusion of the left anterior descending artery and were then reperfused for 120 min. Reperfusion resulted in an increase in (23)Na (37 +/- 18% of the posterior wall) and decrease in (87)Rb (55 +/- 15%) image intensities, partial recovery of PCr, ATP, the total phosphates, and MbO(2) in the anterior wall. The above changes are consistent with the irreversible cell damage in the anterior wall, confirmed by lack of staining with triphenyltetrazolium chloride. Changes in Na(+) and Rb(+) in the infarct area inversely correlated and their ratio is a more sensitive index of cell injury than either of them alone.

Animals↗

Effects of retrograde cardioplegia on myocardial perfusion and energy metabolism in immature porcine myocardium.

OBJECTIVES: Retrograde cardioplegia has been widely used for the protection of adult hearts during cardiac operations. Its efficacy to protect immature myocardium is still unclear. This study was designed to assess the effects of retrograde cardioplegia on myocardial perfusion and energy metabolism in immature hearts. METHODS: Piglet hearts were divided into 3 groups. Hearts in group 1 were used to assess myocardial perfusion of retrograde cardioplegia by means of magnetic resonance imaging. Hearts in groups 2 and 3 were used to assess the effects of retrograde cardioplegia on myocardial energy metabolism by use of phosphorus 31 magnetic resonance spectroscopy. RESULTS: Magnetic resonance images showed that perfusion with retrograde cardioplegic solution was heterogeneous. A perfusion defect was noted during retrograde cardioplegia in the right ventricular wall and in a portion of the posterior wall of the left ventricle in 4 of 6 hearts. Phosphorus 31 spectra showed that at the end of 45-minute retrograde cardioplegia, myocardial intracellular pH was 6.83 +/- 0.17 and phosphocreatine was 53.5% +/- 27% of its prearrest value. The adenosine triphosphate level, however, remained normal throughout the retrograde cardioplegia period. Last, the hearts subjected to retrograde cardioplegia or antegrade cardioplegia showed similar and complete metabolic and functional recovery during reperfusion. CONCLUSIONS: Retrograde cardioplegia provides heterogeneous perfusion. Its ability to protect the right ventricular myocardium is poor and varies between individuals. Myocardial perfusion provided by retrograde cardioplegia is slightly less than that needed to sustain normal myocardial energy metabolism under normothermic conditions.

Animals↗

The effects of retrograde cardioplegia technique on myocardial perfusion and energy metabolism: a magnetic resonance imaging and localized phosphorus 31 spectroscopy study in isolated pig hearts.

OBJECTIVE: The present work was designed to study the myocardial perfusion and energy metabolism during retrograde cardioplegia performed with different methods, including deep coronary sinus cardioplegia, coronary sinus orifice cardioplegia, and right atrial cardioplegia. METHODS: Isolated pig hearts were subjected to antegrade cardioplegia, right atrial cardioplegia, deep coronary sinus cardioplegia, and coronary sinus orifice cardioplegia in a random order. Cardioplegic distribution was assessed by T1-weighted magnetic resonance imaging in 1 group of hearts (n = 8). The flow dynamics of cardioplegia were assessed by T2*-weighted imaging in a second group of hearts (n = 8). RESULTS: T1-weighted images revealed an apparent perfusion defect in the posterior wall of the left ventricle, the posterior portion of the interventricular septum, and the right ventricular free wall during deep coronary sinus cardioplegia. The perfusion defect observed in the first 2 regions with deep coronary sinus cardioplegia resolved with coronary sinus orifice cardioplegia. Right atrial cardioplegia provided the most homogeneous perfusion to all regions of the myocardium relative to the other 2 retrograde cardioplegia modalities. T2*-weighted images showed that the 3 retrograde cardioplegia modalities provided similar cardioplegic flow velocities. Localized phosphorus 31 spectroscopy showed that the levels of adenosine triphosphate and phosphocreatine were significantly lower in the posterior wall (adenosine triphosphate, 42.86% +/- 5.91% of its initial value; phosphocreatine, 11.43% +/- 11.3%) than the anterior wall (adenosine triphosphate, 89.19% +/- 8.83%; phosphocreatine, 59.54% +/- 12.58%) of the left ventricle during 70 minutes of normothermic deep coronary sinus cardioplegia. CONCLUSIONS: Deep coronary sinus cardioplegia results in myocardial ischemia in the posterior wall of the left ventricle and the posterior portion of the interventricular septum, as well as in the right ventricular free wall. Coronary sinus orifice cardioplegia improves cardioplegic distribution in these regions. Relative to deep coronary sinus cardioplegia and coronary sinus orifice cardioplegia, right atrial cardioplegia provides the most homogeneous perfusion.

Adenosine Triphosphate↗

Subclinical rejection--a potential surrogate marker for chronic rejection--may be diagnosed by protocol biopsy or urine spectroscopy.

Our studies of protocol biopsy studies have shown that normal allograft histology can not be assumed by crude tests of renal function such as the serum creatinine concentration, and that there is a high prevalence of subclinical rejection in the first 6 months post-transplant (7, 13-17). The apparent ability of urine MR and IR spectra to reliably identify patients with normal allograft histology, if confirmed in a larger database, will preclude the need for a protocol biopsy in approximately 20-50% of patients. Conversely, finding urine MR or IR spectra characteristic of subclinical rejection would provide the opportunity for early treatment. The clear separation between patients with normal histology from those with subclinical rejection can be attributed to the use of the whole urine spectrum to develop the classifiers. Additional advantages of using MR or IR spectra of urine as a diagnostic tool compared to the biopsy include simplicity (i.e. no processing is required), low cost, rapid turnaround (i.e. < 15 minutes/sample), and, particularly, low risk, thus allowing for repetitive sampling. The ability to non-invasively diagnose acute inflammation in the kidney would be of great assistance in the post-transplant monitoring of renal transplant patients. Indeed, by following subclinical inflammation as detected in the MR/IR spectra it will be possible to tailor the intensity of the immunosuppression to the inflammatory status of the graft, thus minimising the risks of both insufficient and excessive immunosuppression. Furthermore, by following subclinical inflammation, as detected in the MR/IR spectra, it will be possible to test the hypothesis that subclinical rejection (i.e. persistence of its MR/IR spectral classifier) is a surrogate marker for the development of chronic rejection.

Acute Disease↗

Unilateral antegrade cerebral perfusion through the right axillary artery provides uniform flow distribution to both hemispheres of the brain: A magnetic resonance and histopathological study in pigs.

BACKGROUND: Bilateral antegrade cerebral perfusion (ACP) has decreased in popularity over the past decade because of its complexity and the risk of cerebral embolism. We used magnetic resonance (MR) perfusion imaging to assess flow distribution in both hemispheres of the brain during unilateral ACP through the right carotid artery via a cannula placed in the right axillary artery in conjunction with hypothermic circulatory arrest. METHODS AND RESULTS: Twelve pigs were randomly exposed to 120 minutes of either bilateral ACP through both carotid arteries (n=6) or unilateral ACP through the right axillary artery (n=6) at pressures of 60 to 65 mm Hg at 15 degrees C, followed by 60 minutes of cardiopulmonary bypass at 37 degrees C. MR perfusion images were acquired every 30 minutes before, during, and after ACP. The brain was perfusion fixed for histopathology. During initial normothermic cardiopulmonary bypass, MR perfusion imaging showed a uniform distribution of flow in the brain. In both the bilateral and unilateral ACP groups, the same pattern was maintained, with an increase in regional cerebral blood volume during ACP and reperfusion. The changes in regional cerebral blood volume and mean transit time were similar in both hemispheres during and after unilateral ACP. No difference was observed between the 2 groups. Histopathology showed normal morphology in all regions of the brain in both groups. CONCLUSIONS: Both bilateral ACP and unilateral ACP provide uniform blood distribution to both hemispheres of the brain and preserve normal morphology of the neurons after prolonged hypothermic circulatory arrest.

Animals↗

The effects of low-flow ischemia on K+ fluxes in isolated rat hearts assessed by 87Rb NMR.

This study investigated whether Na+/K+ ATPase is inhibited and KATP channels activated during low flow ischemia (LFI) by monitoring Rb+ uptake and efflux from rat hearts using 87Rb NMR. In the uptake experiments, isolated Langendorff perfused hearts were exposed to Rb+-containing Krebs-Henseleit buffer (2.14 m m+3.76 m m K+) for 60 min. When Rb+ uptake started the flow of perfusate was decreased from 10 to 1 ml/min/g wet weight for 44 min and then returned to normal. The rate of Rb+ uptake and its equilibrium level decreased to 40 and 65% of the control (no ischemia) levels, respectively. Phosphocreatine and cytoplasmic [ATP]/[ADP] measured by 31P NMR decreased by half, intracellular pH (pHi) decreased to 6.8+/-0.1, and Pi increased two-fold. In wash-out experiments the hearts were pre-loaded with Rb+ for 30 min following which Rb+ wash-out was initiated. Four minutes later, flow was either decreased in the absence or presence of 10 microm 2,4-dinitrophenol (DNP), or 0.1 m m DNP was infused at normal flow for 20 min. LFI resulted in biphasic Rb+ efflux; during the initial phase, which lasted 8 min, the rate constant (kx10(3)/min) did not differ from control (43+/-3). The efflux was slightly inhibited by 5 microm glibenclamide (36+/-6) or 100 microm 5-hydroxydecanoic acid (32+/-4). In the second phase k decreased to half its initial value (18+/-2). More significant changes in energy state caused by LFI+10 microm DNP had no effect on the efflux kinetics. Similar changes in energy state induced by 0.1 m m DNP at normal flow were associated with activation of Rb+ efflux (71+/-5). DNP-stimulated Rb+ efflux was inhibited by acidosis (pHi approximately pHe = 6.7) produced with 5 m m morpholinoethane sulphonic acid (53+/-5) and by 100 microm adenosine (58+/-7). We suggest that accumulation of ischemic products such as H+and adenosine decreases activation of KATP channels in rat hearts.

2,4-Dinitrophenol↗

Does retrograde warm blood cardioplegic perfusion provide better protection of ischemic areas than antegrade warm blood cardioplegic perfusion? A magnetic resonance study in pig hearts.

OBJECTIVE: The purpose of this study was to determine whether retrograde continuous normothermic blood cardioplegic perfusion provides better protection to ischemic areas of the left and right ventricles than does antegrade continuous normothermic blood cardioplegic perfusion. Localized phosphorus 31 magnetic resonance spectroscopy was used to monitor the changes in energy metabolism and intracellular pH in the ventricles of pig hearts. METHODS: Ten isolated pig hearts received 20 minutes of antegrade continuous normothermic blood cardioplegic perfusion for collection of control (baseline) data, followed by 60 minutes of either antegrade continuous normothermic blood cardioplegic perfusion (n = 5) or retrograde continuous normothermic blood cardioplegic perfusion (n = 5) with occlusion of the left anterior descending and the right coronary arteries. The hearts were then subjected to antegrade continuous normothermic blood cardioplegic perfusion for 20 minutes. The perfusion pressures were maintained between 80 and 100 mm Hg and between 38 and 43 mm Hg during antegrade and retrograde continuous normothermic blood cardioplegic perfusions, respectively. Intracellular pH and creatine phosphate, inorganic phosphate, and adenosine triphosphate levels were measured continuously in each ventricle by means of localized phosphorus 31 magnetic resonance spectroscopy with 2 surface coils. RESULTS: Both antegrade and retrograde continuous normothermic blood cardioplegic perfusion resulted in a significant increase in inorganic phosphate level and decreases in creatine phosphate level, adenosine triphosphate level, and intracellular pH. No significant differences in these changes were observed between the two groups. The creatine phosphate and adenosine triphosphate levels were significantly lower in the right ventricle than in the left ventricle during retrograde continuous normothermic blood cardioplegic perfusion. On reperfusion, the inorganic phosphate level, creatine phosphate level, and intracellular pH recovered completely; however, no recovery in the adenosine triphosphate level was seen in the ventricles of either group. CONCLUSIONS: Retrograde continuous normothermic blood cardioplegic perfusion does not provide better protection to ischemic areas of the ventricles than does antegrade continuous normothermic blood cardioplegic perfusion under our experimental conditions.

Adenosine Triphosphate↗

Measurements of mitochondrial K+ fluxes in whole rat hearts using 87Rb-NMR.

The rubidium efflux from hypothermic rat hearts perfused by the Langendorff method at 20 degreesC was studied. At this temperature 87Rb-NMR efflux experiments showed the existence of two 87Rb pools: cytoplasmic and mitochondrial. Rat heart mitochondria showed a very slow exchange of mitochondrial Rb+ for cytoplasmic K+. After washout of cytosolic Rb+, mitochondria kept a stable Rb+ level for >30 min. Rb+ efflux from mitochondria was stimulated with 0.1 mM 2, 4-dinitrophenol (DNP), by sarcolemmal permeabilization and concomitant cellular energy depletion by saponin (0.01 mg/ml for 4 min) in the presence of a perfusate mimicking intracellular conditions, or by ATP-sensitive K (KATP) channel openers. DNP, a mitochondrial uncoupler, caused the onset of mitochondrial Rb+ exchange; however, the washout was not complete (80 vs. 56% in control). Energy deprivation by saponin, which permeabilizes the sarcolemma, resulted in a rapid and complete Rb+ efflux. The mitochondrial Rb+ efflux rate constant (k) decreased in the presence of glibenclamide, a KATP channel inhibitor (5 microM; k = 0.204 +/- 0.065 min-1; n = 8), or in the presence of ATP plus phosphocreatine (1.0 and 5.0 mM, respectively; k = 0.134 +/- 0.021 min-1; n = 4) in the saponin experiments (saponin only; k = 0.321 +/- 0.079 min-1; n = 3), indicating the inhibition of mitochondrial KATP channels. Thus hypothermia in combination with 87Rb-NMR allowed the probing of the mitochondrial K+ pool in whole hearts without mitochondrial isolation.

2,4-Dinitrophenol↗

pH regulation of K(+) efflux from myocytes in isolated rat hearts: (87)Rb, (7)Li, and (31)P NMR studies.

This study investigates the effects of intracellular (pH(i)) and extracellular pH (pH(e)) on the efflux of Rb(+) and Li(+) in isolated rat hearts. (87)Rb and (7)Li NMR were used to measure Rb(+) and Li(+) content, respectively, of hearts, and (31)P NMR was used to monitor pH(i), pH(e), and phosphate levels. After 30-min equilibration with Rb(+) or Li(+), effluxes were initiated by switching perfusion to a Rb(+)- or Li(+)-free, high-K(+) (20.7 mM) Krebs-Henseleit buffer with 15 microM bumetanide. Monensin (2 microM) increased pH(i) from 7.10 +/- 0.05 to 7.32 +/- 0.07 and resulted in activation of Rb(+) efflux; the first-order rate constant (k x 10(3), in min(-1)) increased from 42 +/- 2 to 116 +/- 16. Glibenclamide (4 microM) did not inhibit monensin-activated Rb(+) efflux (k = 110 +/- 17), whereas quinine (0.2 mM) slightly inhibited it by 19 +/- 9%. Infusion of 15 mM NH(4)Cl during Rb(+) washout increased k for Rb(+) efflux by 93% (81 +/- 8), which was glibenclamide and quinine insensitive, and caused a transient increase in pH(i) to 7.25 +/- 0.08. Intracellular Li(+) inhibited NH(4)Cl-stimulated Rb(+) efflux by 55%. Monensin and NH(4)Cl stimulated Li(+) efflux by 40%, increasing k from 29 +/- 3 to 43 +/- 7 and 41 +/- 3, respectively. The stimulation was not sensitive to 10 microM dimethylamiloride. Intracellular acidosis that resulted from the washout of NH(4)Cl (pH 6.86 +/- 0.2) slightly inhibited Rb(+) efflux (k = 36 +/- 5), whereas NH(4)Cl itself in the absence of pH(i) changes did not markedly affect Rb(+) efflux. A moderate increase in pH(i) (7.17 +/- 0.06) produced by washout of 15 mM 2, 2-dimethylpropionate (DMP)-Tris from hearts preequilibrated with DMP did not markedly affect Rb(+) efflux. Neither global alkalosis (pH(i) 7.4, pH(e) 7.55) nor acidosis (pH(i) approximately pH(e) 6.8) produced by 3 mM Tris base or 5 mM MES, respectively, affected Rb(+) efflux. We suggest that intracellular alkalosis stimulates Rb(+) (K(+)) and Li(+) effluxes by activating a nonselective sarcolemmal K(+) (Li(+))/cation exchanger or a K(+) (Li(+))-anion symporter.

Acidosis↗

An interleaved T1-T2* imaging sequence for assessing myocardial injury.

We developed a sequence by which T1- and T2*-weighted images can be acquired simultaneously and demonstrated its validity for assessing myocardial injury. The interleaved T1-T2* imaging sequence consisted of one preparatory pulse (a 90 degrees pulse) and a gradient-echo imaging sequence with a dynamically variable echo time varying between 4.2 msec for T1-weighted imaging and 15 msec for T2*-weighted imaging. The sequence was tested and validated on isolated blood-perfused pig hearts (n = 4). We found that contrast agent-induced T1 and T2* effects were clearly delineated during the first-pass and steady-state periods of a contrast agent (gadolinium diethylenetriaminopentaacetic acid). With a bolus injection of contrast agent, the maximum changes in T2* signal intensity occur significantly earlier than the changes in T1 signal. We also found that the maximum change in T1 signal intensity during the first pass of contrast agent was significantly greater in a reperfused-infarcted region than in normal regions. The suppression of T2* signal was similar in both regions. At steady state of contrast agent, T2* signal intensities gradually recovered to a significantly higher level in the reperfused-infarcted region than in normal regions. This suggests that the contrast agent diffused into the intracellular space, indicating the loss of cell membrane integrity. As a result, T1 signal intensity was also higher in the reperfused-infarcted myocardium than in normal myocardium. T1- and T2*-weighted images can be acquired simultaneously. The interleaved T1-T2* sequence is useful in assessing myocardial injury.

Animals↗