In isolated mammalian heart muscle, changes in myocardial contractility following acid-base disturbances appear to be driven by Pco2 or intracellular pH rather than extracellular pH.
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May implicate intracellular pH or Pco2 over extracellular pH in contractility; leaves open relevance to human acid-base management.
In-vitro experiments performed in cat papillary muscles and strips of rat right ventricle suggest that the changes in myocardial contractility that follow acid-base disturbances are not a function of extracellular pH. Simultaneous changes in Pco 2 and NaHCO 3 concentration, with extracellular pH constant, decreased developed tension and maximal rate of rise of the tension (dT/dt) without significant changes in the time to peak tension when the muscle was exposed to the solution with higher Pco 2 and NaHCO 3 concentration. At an extracellular pH of 7.40, developed tension decreased 0.51 ± 0.13 g/mm 2 ( P < 0.02) and dT/dt decreased 1.29 ± 0.50 g/sec ( P < 0.05) with no significant change in time to peak tension (0.038 ± 0.022 sec). Changes in pH produced by increasing Pco 2 at constant NaHCO 3 concentration were followed by a significant decrease in contractility. A change of Pco 2 from 20 to 90 mm Hg that produced a change in extracellular pH from 7.60 to 7.00 was accompanied by a decrease in developed tension of 0.67 ± 0.14 g/mm 2 ( P < 0.01), in dT/dt of 2.63 ± 0.54 g/sec ( P < 0.01) with no changes in time to peak tension (0.0017 ± 0.10 seconds). We were unable to show significant variations in contractility when extracellular pH was changed at a constant Pco 2 of approximately 21 mm Hg (NaHCO 3 7.5, 15, and 30 m M ) or at a Pco 2 of approximately 95 mm Hg (NaHCO 3 15, 30, 60, 80 and 120 m M ). Only when extracellular pH reached a value as high as 8.0 (Pco 2 21 mm Hg, NaHCO 3 80 m M ) a small but significant increase in contractility was evidenced. Either Pco 2 or intracellular pH could be the major determinants of the changes in myocardial contractility that follow acid-base alterations.
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Cingolani et al. (1970) studied this question.
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