Cardiac Perfusion, Past and Present
In its early phase cardiac metabolism was exclusively concerned with the nutrition of the heart. The isolated perfused organ appeared to be ideally suited for that purpose. Most of this work has been admirably summarized in 1926 in “A Text Book of Physiology” by Robert A. Tigerstedt, the discoverer of the enzyme renin (1). One section of this book deals with the “chemical conditions for the beating heart.” Prominent amongst the frequently quoted pioneers are Ludwig, Langendorff, Kronecker, Howell, Martin, Greene, Gaskell, Bowditch. Clark, Loewi, Locke, and particularly Ringer (1). Starling and Evans play a predominant role in the investigation of the use of organic material by the heart (2). In 1983 as we celebrate Ringer’s centennial, the work of Ringer is particularly pertinent. It is amusing to read that Ringer, investigating the role of calcium in cardiac contraction was first misled by using tap water for perfusion. Tap water, as he discovered later, contained not only CaCl but also KCl which antagonized the calcium effect (1). One year later Ringer discovered that the arrested heart could be made to beat again by the addition of calcium chloride. In 1883 he concluded that calcium is essential for maintenance of cardiac contraction (1).
KeywordsCoronary Flow Creatine Phosphate Myocardial Oxygen Consumption Cardiac Contraction Coronary Spasm
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