Myocardial protection against global ischemia with Krebs-Henseleit buffer-based cardioplegic solution

Journal of Cardiothoracic Surgery

Timur D Vlasov²  Dmitry I Kurapeev¹  Yuri V Dmitriev¹  Michael M Galagudza²  Sarkis M Minasian² 

[1] Institute of Experimental Medicine, V. A. Almazov Federal Heart, Blood and Endocrinology Centre, Saint Petersburg, Russia;Department of Pathophysiology, I. P. Pavlov Federal Medical University, Saint Petersburg, Russia

关键词: Myocardial protection/cardioplegia;    Ischemia/reperfusion injury;    Heart;   

Others  :  826252
DOI  :  10.1186/1749-8090-8-60

 received in 2012-12-29, accepted in 2013-03-25,  发布年份 2013

【 摘 要 】

Background

The Krebs-Henseleit buffer is the best perfusion solution for isolated mammalian hearts. We hypothesized that a Krebs-Henseleit buffer-based cardioplegic solution might provide better myocardial protection than well-known crystalloid cardioplegic solutions because of its optimal electrolyte and glucose levels, presence of buffer systems, and mild hyperosmolarity.

Methods

Isolated Langendorff-perfused rat hearts were subjected to either global ischemia without cardioplegia (controls) or cardioplegic arrest for either 60 or 180 min, followed by 120 min of reperfusion. The modified Krebs-Henseleit buffer-based cardioplegic solution (mKHB) and St. Thomas’ Hospital solution No. 2 (STH2) were studied. During global ischemia, the temperatures of the heart and the cardioplegic solutions were maintained at either 37°C (60 min of ischemia) or 22°C (moderate hypothermia, 180 min of ischemia). Hemodynamic parameters were registered throughout the experiments. The infarct size was determined through histochemical examination.

Results

Cardioplegia with the mKHB solution at moderate hypothermia resulted in a minimal infarct size (5 ± 3%) compared to that in the controls and STH2 solution (35 ± 7% and 19 ± 9%, respectively; P < 0.001, for both groups vs. the mKHB group). In contrast to the control and STH2-treated hearts, no ischemic contracture was registered in the mKHB group during the 180-min global ischemia. At normothermia, the infarct sizes were 4 ± 3%, 72 ± 6%, and 70 ± 12% in the mKHB, controls, and STH2 groups, respectively (P < 0.0001). In addition, cardioplegia with mKHB at normothermia prevented ischemic contracture and improved the postischemic functional recovery of the left ventricle (P < 0.001, vs. STH2).

Conclusions

The data suggest that the Krebs-Henseleit buffer-based cardioplegic might be superior to the standard crystalloid solution (STH2).

【 授权许可】

   
2013 Minasian et al.; licensee BioMed Central Ltd.

【 图 表 】

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