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Research Article Free access | 10.1172/JCI107126

Improvement in Myocardial Function and Coronary Blood Flow in Ischemic Myocardium after Mannitol

James T. Willerson, Wm. John Powell Jr., Timothy E. Guiney, James J. Stark, Charles A. Sanders, and Alexander Leaf

Department of Medicine (Cardiac and Renal Units), Massachusetts General Hospital, Boston, Massachusetts 02114

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02114

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Department of Medicine (Cardiac and Renal Units), Massachusetts General Hospital, Boston, Massachusetts 02114

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02114

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Department of Medicine (Cardiac and Renal Units), Massachusetts General Hospital, Boston, Massachusetts 02114

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02114

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Department of Medicine (Cardiac and Renal Units), Massachusetts General Hospital, Boston, Massachusetts 02114

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02114

Find articles by Stark, J. in: JCI | PubMed | Google Scholar

Department of Medicine (Cardiac and Renal Units), Massachusetts General Hospital, Boston, Massachusetts 02114

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02114

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Department of Medicine (Cardiac and Renal Units), Massachusetts General Hospital, Boston, Massachusetts 02114

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02114

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Published December 1, 1972 - More info

Published in Volume 51, Issue 12 on December 1, 1972
J Clin Invest. 1972;51(12):2989–2998. https://doi.org/10.1172/JCI107126.
© 1972 The American Society for Clinical Investigation
Published December 1, 1972 - Version history
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Abstract

The purpose of this study was to evaluate the effect of hyperosmolality on the performance of, and the collateral blood flow to, ischemic myocardium. The myocardial response to mannitol, a hyperosmolar agent which remains extracellular, was evaluated in anesthetized dogs. Mannitol was infused into the aortic roots of 31 isovolumic hearts and of 15 dogs on right heart bypass, before and during ischemia. Myocardial ischemia was produced by temporary ligation of either the proximal or mid-left anterior descending coronary artery.

Mannitol significantly improved the depressed ventricular function curves which occurred with left anterior descending coronary artery occlusion. Mannitol also significantly lessened the S-T segment elevation (epicardial electrocardiogram) occurring during myocardial ischemia in the isovolumic hearts and this reduction was associated with significant increases in total coronary blood flow (P < 0.005) and with increased collateral coronary blood flow to the ischemia area (P < 0.005).

Thus, increases in serum osmolality produced by mannitol result in the following beneficial changes during myocardial ischemia: (a) improved myocardial function, (b) reduced S-T segment elevation, (c) increased total coronary blood flow, and (d) increased collateral coronary blood flow.

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Version history
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