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British Journal of Anaesthesia, 2002, Vol. 88, No. 1 78-86
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Laboratory Investigations

Effects of intracoronary calcium chloride on regional oxygen balance and mechanical function in normal and stunned myocardium in dogs

K. Y. Yoo*,1, J. U. Lee2, S. H. Kwak1, W. M. Im1, C. Y. Jeong1, S. S. Chung1, M. H. Yoon1, S. W. Jeong1 and J. T. Park2

1Department of Anesthesiology, Chonnam National University Medical School, 8 Hak-dong, Kwangju 501-746, Korea. 2Chonnam University Research Institute of Medical Sciences, 5 Hak-dong, Kwangju 501-746, Korea*Corresponding author

Background. Brief myocardial ischaemia has been demonstrated to result in mechanical and coronary endothelial dysfunction, in which calcium may play a role. We examined whether the mechanical and vascular responses to calcium are altered in postischaemic, reperfused myocardium.

Methods. Regional myocardial oxygen consumption (MV·O2), mechanical function and coronary blood flow (CBF) in response to calcium chloride (0.10, 0.25, 0.50 and 0.75 mg ml–1 of CBF) directly infused into the left anterior descending (LAD) artery were determined before (normal) and 30 min after a 15-min-period of LAD occlusion (stunned) in an open-chest canine model. Percentage segment shortening (%SS) and percentage postsystolic shortening (%PSS) in the LAD territory were determined using ultrasonic crystals and CBF using a Doppler transducer. Myocardial extraction of oxygen (EO2) and lactate (Elac) was calculated.

Results. The infusion of calcium chloride resulted in dose-dependent increases in %SS and MV·O2 but did not affect %PSS in normal myocardium. These changes were accompanied by parallel increases in CBF, resulting in no change in EO2. In stunned myocardium, the responses to calcium chloride were not significantly altered, with the exception of a reduction in %PSS. However, ischaemia and reperfusion itself significantly reduced %SS and Elac and increased %PSS.

Conclusions. These data suggest that calcium chloride improves regional systolic and diastolic function both in normal and stunned myocardium. Calcium chloride is unlikely to cause direct coronary vasoconstriction or to deteriorate regional mechanical function in postischaemic myocardium.

Br J Anaesth 2002; 88: 78–86


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