Multi-dose crystalloid cardioplegia preserves intracellular sodium homeostasis in myocardium.

The goal of this study was to assess the effect of multi-dose St Thomas' cardioplegia on intracellular sodium homeostasis in a rat heart model. A new magnetic resonance method was applied which enable us to detect intracellular Na changes without chemical shift reagents. Three groups of isolated rat hearts were subjected to 51 min of ischemia and 51 min of reperfusion at 37 degrees C: Group 1-three infusions of St Thomas' cardioplegia every 17 min for 2 min (n=7); Group 2-single-dose infusion of cardioplegia at the beginning of stop-flow ischemia (n=8); and Group 3-clamp ischemia (n=3) without cardioplegia administration. Performance of the heart was assessed by rate-pressure product relative to the pre-ischemic level (RPP). An NMR method was applied which continuously detects the Na(i) concentration in the heart, using the ability of bound sodium to exhibit triple-quantum transitions and the growth of the corresponding signal when sodium ions pass from extracellular to intracellular space. Clamp ischemia without cardioplegia and 50 min of reperfusion left the heart dysfunctional, with Na(i) growth from the pre-ischemic level of 13.9+/-1.2 mM to 34.9+/-1.3 mM and 73. 9+/-1.9 mM at the end of ischemia and reperfusion, respectively. During single-dose cardioplegia the corresponding values for Na(i) were 30.2+/-1 mM and 48.5+/-1.7 mM (RPP=29%). Multiple infusions of cardioplegic solution resulted in a remarkable preservation of the heart's intracellular Na concentration with a non-significant increase in Na(i) during ischemia and only 16.7+/-1 mM, (P=0.01), after subsequent reperfusion (RPP=85%). The time course of Na(i) changes in the rat heart model demonstrates a prominent potential of multi-dose St Thomas' cardioplegia in preserving intracellular sodium homeostasis at 37 degrees C. The growth of Na(i) concentration during ischemia, as an indicator of the viability of the myocytes, can have a prognostic value for the heart's performance during reperfusion.

Sodium TQF NMR and intracellular sodium in isolated crystalloid perfused rat heart.

The feasibility of monitoring intracellular sodium changes using Na triple quantum filtered NMR without a chemical shift reagent (SR) was investigated in an isolated rat heart during a variety of interventions for Na(i) loading. Perfusion with 1 mM ouabain or without K+ present in the perfusate for 30 min produced a rise of the Na TQF signal with a plateau of approximately 190% and approximately 228% relative to the preintervention level, respectively. Stop-flow ischemia for 30 min resulted in a TQF signal growth of approximately 147%. The maximal Na TQF signal increase of 460% was achieved by perfusion without K+/Ca2+, corresponding to an elimination of the Na transmembrane gradient. The observed values of Na NMR TQF growth in the physiological and pathological ranges are in agreement with reported data by other methods and have a linear correlation with intracellular sodium content as determined in this study by Co-EDTA method and by sucrose-histidine washout of the extracellular space. Our data indicate that the increase in Na TQF NMR signal is determined by the growth of Na(i), and the extracellular Na contribution to the total TQF signal is unchanged at approximately 64%. In conclusion, Na TQF NMR without using SR offers a unique and noninvasive opportunity to monitor alterations of intracellular sodium. It may provide valuable insights for developing cardioprotective strategies and for observing the effects of pharmaceutical treatments on sodium homeostasis.

Effects of specific sodium/hydrogen exchange inhibitor during cardioplegic arrest.

BACKGROUND: The accumulation of intracellular sodium during myocardial ischemia couples an inappropriate calcium influx and depressed cardiac recovery during subsequent reperfusion. The effects of the selective sodium/ hydrogen exchange inhibitor HOE 694 are evaluated during myocardial ischemia and reperfusion. METHODS: Ten isolated rat hearts were subjected to a 2-minute infusion of St. Thomas' cardioplegia +/- 1 mumol/L HOE 694 followed by 50 minutes' normothermic (37 degrees C) global ischemia. Intracellular sodium accumulation was continuously measured using triple quantum filtered 23Na nuclear magnetic resonance spectroscopy without chemical shift reagents. Hemodynamic variables were assessed before and after ischemia. RESULTS: The addition of 1 mumol/L HOE 694 to St. Thomas cardioplegic solution (n = 5) attenuated the accumulation of intracellular sodium after 50 minutes' ischemia (160.5% +/- 9.1% versus 203.4% +/- 10.9% [mean +/- standard error], HOE 694 versus control, respectively; p = 0.014) and after the initial reperfusion period (first 30 minutes) (288.7% +/- 10.2% versus 335.9% +/- 10.3%; p = 0.008). HOE 694-treated hearts showed significantly improved postischemic recovery of left ventricular developed pressure (53.5% +/- 8.4% versus 26.4% +/- 6.6%; p = 0.036) and rate-pressure product (40.2% +/- 6.9% versus 13.2% +/- 5%; p = 0.014). Postischemic recovery of coronary flow was not significantly different between the two groups (68.6% +/- 5.9% versus 55.5% +/- 4.6%, HOE 694 versus control, respectively; p = 0.11). CONCLUSIONS: The addition of 1 mumol/L HOE 694 to cardioplegic solution attenuates the increase of intracellular sodium during myocardial ischemia and early reperfusion. This is coupled with an improved recovery of contractile function, possibly as a result of decreased sodium and calcium overload of ischemic myocardium.

Four-dimensional 1H and 23Na imaging using continuously oscillating gradients.

A class of fast magnetic spectroscopic imaging methods using continuously oscillating gradients for four-dimensional (three spatial and one spectral) localization is introduced. Sampling may start immediately following the application of an RF excitation pulse, thus enabling measurement of spin density, chemical shift, and relaxation rates of short-T2 species. For spatial localization, steady-state sinusoidal gradient waveforms are used to sample a ball in k space. The two types of trajectories presented include: (1) continuously oscillating gradients with continuously rotating direction used for steady-state free-precession imaging and (2) continuously oscillating gradients followed by a spoiler directed along discrete projections. Design criteria are given and spatial-spectral and spatial-temporal reconstruction methods are developed. Theoretical point-spread functions and signal-to-noise ratios are derived while considering T2*, off-resonance effects, and RF excitation options. Experimental phantom, in vivo, and in vitro 1H and 23Na images collected at 2.35 T are presented. The 1H images were acquired with isotropic spatial resolution ranging from 0.03 to 0.27 cm3 and gradient-oscillation frequencies ranging from 600 to 700 Hz, thus allowing for the separation of water and lipid signals within a voxel. The 23Na images, acquired with 500 and 800 Hz gradient waveforms and 0.70 cm3 isotropic resolution, were resolved in the time domain, yielding spatially localized FIDs.

In vivo NMR and MRI using injection delivery of laser-polarized xenon.

Because xenon NMR is highly sensitive to the local environment, laser-polarized xenon could be a unique probe of living tissues. Realization of clinical and medical science applications beyond lung airspace imaging requires methods of efficient delivery of laser-polarized xenon to tissues, because of the short spin-lattice relaxation times and relatively low concentrations of xenon attainable in the body. Preliminary results from the application of a polarized xenon injection technique for in vivo 129Xe NMR/MRI are extrapolated along with a simple model of xenon transit to show that the peak local concentration of polarized xenon delivered to tissues by injection may exceed that delivered by respiration by severalfold.

Sodium alterations in isolated rat heart during cardioplegic arrest.

Triple-quantum-filtered (TQF) Na nuclear magnetic resonance (NMR) without chemical shift reagent is used to investigate Na derangement in isolated crystalloid perfused rat hearts during St. Thomas cardioplegic (CP) arrest. The extracellular Na contribution to the NMR TQF signal of a rat heart is found to be 73 +/- 5%, as determined by wash-out experiments at different moments of ischemia and reperfusion. With the use of this contribution factor, the estimated intracellular Na ([Na+]i) TQF signal is 222 +/- 13% of preischemic level after 40 min of CP arrest and 30 min of reperfusion, and the heart rate pressure product recovery is 71 +/- 8%. These parameters are significantly better than for stop-flow ischemia: 340 +/- 20% and 6 +/- 3%, respectively. At 37 degrees C, the initial delay of 15 min in [Na+]i growth occurs during CP arrest along with reduced growth later (approximately 4.0%/min) in comparison with stop-flow ischemia (approximately 6.7%/min). The hypothermia (21 degrees C, 40 min) for the stop-flow ischemia and CP dramatically decreases the [Na+]i gain with the highest heart recovery for CP (approximately 100%). These studies confirm the enhanced sensitivity of TQF NMR to [Na+]i and demonstrate the potential of NMR without chemical shift reagent to monitor [Na+]i derangements.

Measurement of 129Xe T1 in blood to explore the feasibility of hyperpolarized 129Xe MRI.

OBJECTIVE: The major obstacle to the use of 129-xenon (I = 1/2) as a new source of contrast in magnetic resonance is its low sensitivity. The hyperpolarized 129Xe-MRI technique using laser optical pumping of rubidium promises to resolve this problem. The potential of xenon-based MRI for the body tissues other than the lung air spaces depends on the 129Xe polarization lifetime (T1) in the blood at a magnetic field of commonly available clinical MRI systems. MATERIALS AND METHODS: Xenon with natural abundance of 129Xe (26%) was dissolved in human blood and studied at 36 degrees C in a 2.35 T 40 cm bore MRI spectrometer (27.6 MHz). Zeeman relaxation (T1) of six blood samples was measured by the progressive saturation method for periods of 4-8 h each. RESULTS: NMR spectra revealed two peaks at 216.0 ppm (A) and 194.0 ppm (B) relative to the xenon gas above the blood volume. Assignment and 129Xe T1 values were 4.5 +/- 1 s for red blood cells (A), 9.6 +/- 2 s for plasma (B) and 11.9 +/- 1.6 s for xenon gas at atmospheric oxygen pressure. Xenon dissolved in distilled water appears at 189.8 ppm and has T1 = 26.3 +/- 1.4 s. CONCLUSION: These relaxation times, though shorter than expected, are comparable to the transport time of blood, and are long enough to encourage use of hyperpolarized xenon for MRI studies in tissues, in addition to lung.