[The effect of Belzer and Bretschneider cardioplegia solutions on myocardial energy metabolism. A study with 31phosphorus magnetic resonance spectroscopy in an animal model].

The aim of our study was to test the effectiveness of two cardioplegic solutions and to compare the level of high energy phosphates in the myocardium. We investigated 18 hearts of pigs (obtained from a slaughter-house) with 31phosphorusmagnetic resonance spectroscopy (31P-MRS) In this experiment coronary arteries were cannulated and reperfused with arterial blood to revitalize the heart. When the heart showed regular pulsations coronary arteries were perfused for cardioplegia either with the UW-(Belzer-) or with the HTK-(Bretschneider-)solution. For 31P-MRS, a magnet with a magnetic flux density of 4.7 Tesla (T) was available. Relative concentrations from phosphocreatine (PCr/beta-ATP; high-energy phosphate) and inorganic phosphate (Pi/MDP; MDP = methylendiphosphonat = reference solution; low-energy phosphate) were calculated from the spectra. As a result of this study, the HTK-solution showed a significantly higher PCr/beta-ATP-ratio in the myocardium than the UW-solution during the examination time of 3 h. After plegia of the myocardial area from the right coronary artery PCr/beta-ATP-ratios were lower in comparison with the left coronary artery distribution area. The calculation of Pi/MDP-ratios proved that Pi was higher in the myocardium after application of the UW-solution compared to HTK-solution. The kinetics of the metabolites showed an approximately linear and parallel decrease of PCr/beta-ATP-ratios after cardioplegia with both solutions during the examination time.