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. 1978 Dec;62(6):1194–1200. doi: 10.1172/JCI109239

Reversible depression in myocardial performance in dogs with experimental phosphorus deficiency.

T J Fuller, W W Nichols, B J Brenner, J C Peterson
PMCID: PMC371884  PMID: 748374

Abstract

The effects of phosphorus depletion on cardiac muscle function in six awake dogs were evaluated with surgically implanted transducers to serially measure ascending aortic root blood flow and high fidelity left ventricular pressure. After the animals recovered from surgery, phosphorus depletion was induced by feeding them a synthetic phosphorus-deficient diet plus aluminum carbonate gel for 35 days, followed by the same diet with phosphorus supplementation for 21 days. In addition to the cardiac studies, sequential measurements of phosphorus content in skeletal muscle and phosphorus in serum were obtained to ascertain the level of phosphorus depletion. Serum inorganic phosphorus concentration (mg/100 ml) decreased from 5.1 +/- 0.1 on day 0 to 0.9 +/- 0.1 on day 35 (P less than 0.01), and total muscle phosphorus (content mmul/100 g fat-free dry weight) decreased from 28.0 +/- on day 0 to 22.6 +/- 0.5 on day 35 (P less than 0.01). During the period of phosphorus depletion, there was no significant change in heart rate; however, stroke volume (milliliter) and peak blood flow velocity (centimeter per second) declined from 24 +/- 2 to 17 +/- 2 (P less than 0.01) and 121 +/- 12 to 98 +/- 7 (P less than 0.01), respectively. Maximum ascending aortic blood flow acceleration (centimeter per second square) and maximum left ventricular time rate of change of pressure (mm Hg per second) also decreased from 4,630 +/- 313 to 3,817 +/0 346 (P less than 0.01) and 2,582 +/- 347 to 2,120 +/- 297 (P less than 0.01) during phosphorus depletion. After repletion all values returned to control values. These results indicate that moderate diet-induced phosphorus depletion can depress myocardial performance. With repletion of phosphorus, myocardial performance improves.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnes G. E., Bishop V. S., Horwitz L. D., Kaspar R. L. The maximum derivatives of left ventricular pressure and transverse internal diameter as indices of the inotropic state of the left ventricle in conscious dogs. J Physiol. 1973 Dec;235(3):571–590. doi: 10.1113/jphysiol.1973.sp010405. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Craddock P. R., Yawata Y., VanSanten L., Gilberstadt S., Silvis S., Jacob H. S. Acquired phagocyte dysfunction. A complication of the hypophosphatemia of parenteral hyperalimentation. N Engl J Med. 1974 Jun 20;290(25):1403–1407. doi: 10.1056/NEJM197406202902504. [DOI] [PubMed] [Google Scholar]
  3. Eisele J. H., Trenchard D., Stubbs J., Guz A. The immediate cardiac depression by anaesthetics in conscious dogs. Br J Anaesth. 1969 Feb;41(2):86–93. doi: 10.1093/bja/41.2.86. [DOI] [PubMed] [Google Scholar]
  4. Fuller T. J., Carter N. W., Barcenas C., Knochel J. P. Reversible changes of the muscle cell in experimental phosphorus deficiency. J Clin Invest. 1976 Apr;57(4):1019–1024. doi: 10.1172/JCI108343. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gersh B. J., Hahn C. E., Prys-Roberts C. Physical criteria for measurement of left ventricular pressure and its first derivative. Cardiovasc Res. 1971 Jan;5(1):32–40. doi: 10.1093/cvr/5.1.32. [DOI] [PubMed] [Google Scholar]
  6. Goldfarb S., Westby G. R., Goldberg M., Agus Z. S. Renal tubular effects of chronic phosphate depletion. J Clin Invest. 1977 May;59(5):770–779. doi: 10.1172/JCI108698. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jacob H. S., Amsden T. Acute hemolytic anemia with rigid red cells in hypophosphatemia. N Engl J Med. 1971 Dec 23;285(26):1446–1450. doi: 10.1056/NEJM197112232852602. [DOI] [PubMed] [Google Scholar]
  8. Katz A. M. Congestive heart failure: role of altered myocardial cellular control. N Engl J Med. 1975 Dec 4;293(23):1184–1191. doi: 10.1056/NEJM197512042932309. [DOI] [PubMed] [Google Scholar]
  9. Kezdi P., Stanley E. L., Marshall W. J., Jr, Kordenat R. K. Aortic flow velocity and acceleration as an index of ventricular performance during myocardial infarction. Am J Med Sci. 1969 Jan;257(1):61–71. doi: 10.1097/00000441-196901000-00007. [DOI] [PubMed] [Google Scholar]
  10. Lotz M., Zisman E., Bartter F. C. Evidence for a phosphorus-depletion syndrome in man. N Engl J Med. 1968 Feb 22;278(8):409–415. doi: 10.1056/NEJM196802222780802. [DOI] [PubMed] [Google Scholar]
  11. Mahler F., Ross J., Jr, O'Rourke R. A., Covell J. W. Effects of changes in preload, afterload and inotropic state on ejection and isovolumic phase measures of contractility in the conscious dog. Am J Cardiol. 1975 May;35(5):626–634. doi: 10.1016/0002-9149(75)90048-x. [DOI] [PubMed] [Google Scholar]
  12. O'Connor L. R., Wheeler W. S., Bethune J. E. Effect of hypophosphatemia on myocardial performance in man. N Engl J Med. 1977 Oct 27;297(17):901–903. doi: 10.1056/NEJM197710272971702. [DOI] [PubMed] [Google Scholar]
  13. Quinones M. A., Gaasch W. H., Alexander J. K. Influence of acute changes in preload, afterload, contractile state and heart rate on ejection and isovolumic indices of myocardial contractility in man. Circulation. 1976 Feb;53(2):293–302. doi: 10.1161/01.cir.53.2.293. [DOI] [PubMed] [Google Scholar]
  14. RUSHMER R. F. INITIAL VENTRICULAR IMPULSE. A POTENTIAL KEY TO CARDIAC EVALUATION. Circulation. 1964 Feb;29:268–283. doi: 10.1161/01.cir.29.2.268. [DOI] [PubMed] [Google Scholar]
  15. Rasmussen H. Ionic and hormonal control of calcium homeostasis. Am J Med. 1971 May;50(5):567–588. doi: 10.1016/0002-9343(71)90113-6. [DOI] [PubMed] [Google Scholar]
  16. Ravid M., Robson M. Proximal myopathy caused by latrogenic phosphate depletion. JAMA. 1976 Sep 20;236(12):1380–1381. [PubMed] [Google Scholar]
  17. Suko J., Vogel J. H., Chidsey C. A. Intracellular calcium and myocardial contractility. 3. Reduced calcium uptake and ATPase of the sarcoplasmic reticular fraction prepared from chronically failing calf hearts. Circ Res. 1970 Aug;27(2):235–247. doi: 10.1161/01.res.27.2.235. [DOI] [PubMed] [Google Scholar]
  18. Travis S. F., Sugerman H. J., Ruberg R. L., Dudrick S. J., Delivoria-Papadopoulos M., Miller L. D., Oski F. A. Alterations of red-cell glycolytic intermediates and oxygen transport as a consequence of hypophosphatemia in patients receiving intravenous hyperalimentation. N Engl J Med. 1971 Sep 30;285(14):763–768. doi: 10.1056/NEJM197109302851402. [DOI] [PubMed] [Google Scholar]
  19. Van den Bos G. C., Elzinga C., Westerhof N., Noble M. I. Problems in the use of indices of myocardial contractility. Cardiovasc Res. 1973 Nov;7(6):834–848. doi: 10.1093/cvr/7.6.834. [DOI] [PubMed] [Google Scholar]
  20. Yawata Y., Hebbel R. P., Silvis S., Howe R., Jacob H. Blood cell abnormalities complicating the hypophosphatemia of hyperalimentation: erythrocyte and platelet ATP deficiency associated with hemolytic anemia and bleeding in hyperalimented dogs. J Lab Clin Med. 1974 Nov;84(5):643–653. [PubMed] [Google Scholar]

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