The Ambivalent Value of Cardioplexol

Objectives: Cardioplexol as a crystalloid, low volume, single shot cardioplegic solution has been shown to be effective in clinical studies. To investigate its cardioprotective qualities experimentally, cardiac recovery in rat hearts with Cardioplexol cardioplegia was compared with 45 minutes of no flow ischemia.

Methods: The hearts of 15 rats were isolated and inserted into a blood perfused pressure controlled Langendorff apparatus. After a short period of stabilization, cardioplegic arrest was induced in six hearts by using Cardioplexol as a single dose. In the remaining hearts cardiac arrest was induced by no-flow ischemia without the application of cardioplegic solution. Ischemia was maintained for 45 minutes. During 90 minutes of reperfusion, parameters of cardiac function like left ventricular developed pressure (LVDP), coronary blood flow (CF), and contractile forces were measured and normalized to baseline values (%).

Result: Baseline values of LVPsys, heart rate (HR), and coronary blood flow were similar in both groups (cardioplexol group: LVPsys 94 mm Hg ± 10.84 SEM, HR 245/min ± 16.09 SEM, CF 3.63 mL/min ± 0.49 SEM versus control group: LVPsys 113 mm Hg ± 9.32 SEM, HR: 219/min ± 16.07 SEM, CF: 4.13 mL/min ± 0.26 SEM). Administration of cardioplexol resulted in immediate diastolic cardiac arrest within 1 to 3 seconds. During ischemia, a discernable upcreep of LVDP and contractile force was distinctly measured in the cardioplexol group (LVDP: 4% ± 1 SEM in cardioplexol group versus 1% ± 0.3 SEM in control group). Within the period of reperfusion, hearts after cardioplexol revealed better cardiac recovery in LVDP than hearts after global ischemia (103% ± 29.2 SEM in cardioplexol group versus 73% ± 20 SEM at the beginning of reperfusion; at the end of reperfusion 76% ±10.7 SEM in the cardioplexol group versus 47 ±13.9 SEM in the control group). In early reperfusion, coronary blood flow was higher in the ischemia group than in the cardioplexol group (CF = 119% ± 21 SEM in the cardioplegia group versus 167% ± 27.5 SEM in the ischemia group), but at the end of reperfusion, coronary flow was lower in the ischemia group (CF = 69% ± 15.7 SEM in the cardioplegia group versus 49% ± 9.6 SEM in the ischemia group).

Conclusion: Inducing cardioplegic arrest by cardioplexol results in superior cardiac recovery compared with global no-flow ischemia and is therefore safe and effective. However, ischemic contracture 30 to 39 minutes after cardioplexol infusion warrants further investigation.

Publication History

Article published online:
19 February 2021