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. 1987 Aug;58(2):110–115. doi: 10.1136/hrt.58.2.110

Coronary sinus pH during percutaneous transluminal coronary angioplasty: early development of acidosis during myocardial ischaemia in man.

T Crake, P A Crean, L M Shapiro, A F Rickards, P A Poole-Wilson
PMCID: PMC1277288  PMID: 2956980

Abstract

Coronary sinus pH was measured continuously in eight patients undergoing angioplasty to the left anterior descending coronary artery. A catheter tip pH sensitive electrode with a response time of less than 300 ms and an output of greater than or equal to 57 mV/pH unit was placed high in the coronary sinus. Recordings were obtained during a total of 24 balloon occlusions of the left anterior descending coronary artery varying in duration from 5 to 45 s. Continuous 12 lead surface electrocardiograms were recorded. During or after balloon inflation of greater than or equal to 12 s (n = 4) there was no change in coronary sinus pH or the electrocardiogram. During balloon inflation of greater than or equal to 15 s (n = 20) coronary sinus pH was unaltered but between 4 and 6 s after balloon deflation coronary sinus pH fell transiently by between 0.010 and 0.120 pH units before returning to the control value within 65 s. Ischaemic changes were seen on the electrocardiogram during 15 balloon occlusions. In individual patients the peak fall in coronary sinus pH was related to the duration of occlusion of the left anterior descending coronary artery. A rise in coronary sinus pH (alkalosis) was never seen. In man acidosis occurs in the myocardium after short periods (greater than or equal to 12 s) of ischaemia. The fall of pH precedes ischaemic changes on the surface electrocardiogram and occurs concurrently with the earliest reported changes in contractile function.

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Selected References

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  1. Allen D. G., Morris P. G., Orchard C. H., Pirolo J. S. A nuclear magnetic resonance study of metabolism in the ferret heart during hypoxia and inhibition of glycolysis. J Physiol. 1985 Apr;361:185–204. doi: 10.1113/jphysiol.1985.sp015640. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cobbe S. M., Parker D. J., Poole-Wilson P. A. Tissue and coronary venous pH in ischemic canine myocardium. Clin Cardiol. 1982 Feb;5(2):153–156. doi: 10.1002/clc.4960050206. [DOI] [PubMed] [Google Scholar]
  3. Cobbe S. M., Poole-Wilson P. A. Catheter tip pH electrodes for continuous intravascular recording. J Med Eng Technol. 1980 May;4(3):122–124. doi: 10.3109/03091908009161104. [DOI] [PubMed] [Google Scholar]
  4. Cobbe S. M., Poole-Wilson P. A. Continuous coronary sinus and arterial pH monitoring during pacing-induced ischaemia in coronary artery disease. Br Heart J. 1982 Apr;47(4):369–374. doi: 10.1136/hrt.47.4.369. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cobbe S. M., Poole-Wilson P. A. The time of onset and severity of acidosis in myocardial ischaemia. J Mol Cell Cardiol. 1980 Aug;12(8):745–760. doi: 10.1016/0022-2828(80)90077-2. [DOI] [PubMed] [Google Scholar]
  6. Couper G. S., Weiss J., Hiltbrand B., Shine K. I. Extracellular pH and tension during ischemia in the isolated rabbit ventricle. Am J Physiol. 1984 Dec;247(6 Pt 2):H916–H927. doi: 10.1152/ajpheart.1984.247.6.H916. [DOI] [PubMed] [Google Scholar]
  7. Donaldson R. M., Taggart P., Swanton H., Fox K., Noble D., Rickards A. F. Intracardiac electrode detection of early ischaemia in man. Br Heart J. 1983 Sep;50(3):213–221. doi: 10.1136/hrt.50.3.213. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gaskell W. H. On the Tonicity of the Heart and Blood Vessels. J Physiol. 1880 Aug;3(1):48–92.16. doi: 10.1113/jphysiol.1880.sp000083. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gebert G., Benzing H., Strohm M. Changes in the interstitial pH of dog myocardium in response to local ischemia, hypoxia, hyper- and hypocapnia, measured continuously by means of glass microelectrodes. Pflugers Arch. 1971;329(1):72–81. doi: 10.1007/BF00586901. [DOI] [PubMed] [Google Scholar]
  10. Gudbjarnason S., Mathes P., Ravens K. G. Functional compartmentation of ATP and creatine phosphate in heart muscle. J Mol Cell Cardiol. 1970 Sep;1(3):325–339. doi: 10.1016/0022-2828(70)90009-x. [DOI] [PubMed] [Google Scholar]
  11. Herzig J. W., Peterson J. W., Rüegg J. C., Solaro R. J. Vanadate and phosphate ions reduce tension and increase cross-bridge kinetics in chemically skinned heart muscle. Biochim Biophys Acta. 1981 Jan 21;672(2):191–196. doi: 10.1016/0304-4165(81)90392-5. [DOI] [PubMed] [Google Scholar]
  12. Kentish J. C., Allen D. G. Is force production in the myocardium directly dependent upon the free energy change of ATP hydrolysis? J Mol Cell Cardiol. 1986 Sep;18(9):879–884. doi: 10.1016/s0022-2828(86)80001-3. [DOI] [PubMed] [Google Scholar]
  13. Kentish J. C. The effects of inorganic phosphate and creatine phosphate on force production in skinned muscles from rat ventricle. J Physiol. 1986 Jan;370:585–604. doi: 10.1113/jphysiol.1986.sp015952. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Kübler W., Katz A. M. Mechanism of early "pump" failure of the ischemic heart: possible role of adenosine triphosphate depletion and inorganic phosphate accumulation. Am J Cardiol. 1977 Sep;40(3):467–471. doi: 10.1016/0002-9149(77)90174-6. [DOI] [PubMed] [Google Scholar]
  15. Neely J. R., Rovetto M. J., Whitmer J. T., Morgan H. E. Effects of ischemia on function and metabolism of the isolated working rat heart. Am J Physiol. 1973 Sep;225(3):651–658. doi: 10.1152/ajplegacy.1973.225.3.651. [DOI] [PubMed] [Google Scholar]
  16. Poole-Wilson P. A., Langer G. A. Effect of pH on ionic exchange and function in rat and rabbit myocardium. Am J Physiol. 1975 Sep;229(3):570–581. doi: 10.1152/ajplegacy.1975.229.3.570. [DOI] [PubMed] [Google Scholar]
  17. Poole-Wilson P. A. Measurement of myocardial intracellular pH in pathological states. J Mol Cell Cardiol. 1978 Jun;10(6):511–526. doi: 10.1016/0022-2828(78)90010-x. [DOI] [PubMed] [Google Scholar]
  18. Serruys P. W., Wijns W., van den Brand M., Meij S., Slager C., Schuurbiers J. C., Hugenholtz P. G., Brower R. W. Left ventricular performance, regional blood flow, wall motion, and lactate metabolism during transluminal angioplasty. Circulation. 1984 Jul;70(1):25–36. doi: 10.1161/01.cir.70.1.25. [DOI] [PubMed] [Google Scholar]
  19. Webb S. C., Rickards A. F., Poole-Wilson P. A. Coronary sinus potassium concentration recorded during coronary angioplasty. Br Heart J. 1983 Aug;50(2):146–148. doi: 10.1136/hrt.50.2.146. [DOI] [PMC free article] [PubMed] [Google Scholar]

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