The protective effect of hyperpolarizing blood cardioplegia on isolated rabbit hearts / 中华麻醉学杂志

ABSTRACT

Objective To compare the myocardial protective effect of pinacidil-induced hyperpolarized and hyperkalemic depolarized cardiac arrest on isolated rabbit heart under different temperature. Methods Forty-eight rabbits of both sexes weighing 2.0-2.5 kg were sacrificed by a knock on the head. Their hearts were excised and perfused in a Langendorff apparatus with an oxygenated Krebs-Hensleit buffer (KHB)(37℃). The study was divided into six groups A normothermic hyperkalemic cardioplegia; B normothermic hyperkalemic blood cardioplegia; C hypothermic hyperkalemic cardioplegia; D hypothermia hyperkalemic blood cardioplegia; E normothermic hyperpolarizing blood cardioplegia; F hypothermic hyperpolarizing blood cardioplegia. Three pieces of myocardial tissue were obtained from apex of left ventricle at the end of the study for determination of myocardial adenine nucleotide and lipid peroxide content and microscopic examination. The following were recorded (1) cardiac arrest time the time from perfusion with cardioplegic solution to the beginning of cardiac arrest. (2) heart beat recovery time ;the time from reperfusion with KHB to the beginning of normal heart beat. (3) changes in HR, left ventricle developed pressure and myocardial contractility before and after cardiac arrest. Results The cardiac arrest time was longer and the time for the heart to restart was shorter in the two hyperpolarizing blood cardioplegia groups (group E and F) than that in the other 4 groups. No arrhythmia occurred in group E and F. Left ventricle developed pressure(LVDP) and left ventricle contractility recovered quickly after reperfusion with KHB was started and were restored to the pre-ischemia level after 20 min in group E and F. The levels of ATP, TAN and EC were higher and the MDA level was lower in group E and F than those in the other 4 groups. Myocardial structure was less injuried in group E and F. Conclusion The myocardial protection effect of hyperpolarizing blood cardioplegia with pinacidil is superior to traditional hyperkalemic depolarizing cardioplegia.