Effects of magnesium cardioplegia on regulation of the porcine coronary circulation

J Surg Res. 1997 May;69(2):233-9. doi: 10.1006/jsre.1997.5003.

Abstract

We compared the effect of hypermagnesium and hyperkalemic crystalloid cardioplegia on beta-adrenoceptor-mediated and endothelium-dependent relaxation and myogenic responses of coronary arterioles. Pigs were placed on cardiopulmonary bypass. Hearts were arrested with cold hypermagnesium (25 mM Mg2+, hyper-Mg, n = 12) or hyperkalemic (25 mM K+, hyper-K, n = 12) crystalloid cardioplegia for 1 hr. Hearts of selected pigs (n = 6 in each group) were then reperfused for 1 hr. In vitro relaxation responses of acetylcholine-pre-contracted arterioles were studied in a pressurized no-flow state with video-microscopy. Relaxation of pre-contracted coronary microvessels (70-150 microns) to isoproterenol (beta-adrenergic agonist) and forskolin (adenylate cyclase activator) was preserved after cardioplegia using a hyper-Mg solution. In contrast, responses were impaired to isoproterenol [P < 0.01 (two-factor ANOVA) vs. controls, n = 6] and forskolin (P < 0.01) after hyper-K cardioplegia. After 1 hr of reperfusion, relaxation responses to isoproterenol and forskolin were partially recovered. Hyper-Mg cardioplegia and post-cardioplegic reperfusion did not affect receptor-mediated endothelium-dependent relaxation to ADP, non-receptor-mediated endothelium-dependent relaxation to A23187, and endothelium-independent relaxation to nitroprusside. However, responses to ADP (P < 0.01) and A23187 (P < 0.05) were selectively impaired after hyper-K cardioplegia. Myogenic contraction was impaired after either hyper-Mg or hyper-K cardioplegia. Left ventricular systolic pressure, coronary blood flow, and +dP/dt were similar after hyper-Mg or hyper-K cardioplegia. These results suggest that hyper-Mg cardioplegia is superior to hyper-K cardioplegia in terms of preserving beta-adrenoceptor-mediated and endothelium-dependent regulation of the coronary microcirculation, yet it has minimal if any additional beneficial effect on preserving myogenic responses or myocardial contractile function.

MeSH terms

  • Adrenergic beta-Agonists / pharmacology
  • Animals
  • Blood Pressure
  • Calcimycin / pharmacology
  • Cardioplegic Solutions / chemistry*
  • Cold Temperature
  • Colforsin / pharmacology
  • Coronary Circulation / drug effects*
  • Coronary Vessels / drug effects
  • Endothelium, Vascular / drug effects
  • Female
  • Isoproterenol / pharmacology
  • Magnesium / pharmacology*
  • Male
  • Microcirculation
  • Muscle, Smooth, Vascular / drug effects
  • Nitroprusside / pharmacology
  • Swine
  • Vasodilation / drug effects

Substances

  • Adrenergic beta-Agonists
  • Cardioplegic Solutions
  • Nitroprusside
  • Colforsin
  • Calcimycin
  • Magnesium
  • Isoproterenol