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Thorac Cardiovasc Surg
DOI: 10.1055/s-0043-1772210
Original Basic Science

Myocardial Recovery, Metabolism, and Structure after Cardiac Arrest with Cardioplexol

Carina Hemmerich
1   Department of Cardiovascular Surgery, University Hospitals Giessen and Marburg Campus Giessen, Giessen, Germany
,
Martina Heep
1   Department of Cardiovascular Surgery, University Hospitals Giessen and Marburg Campus Giessen, Giessen, Germany
,
Ulrich Gärtner
2   Institute of Anatomy and Cell Biology, German Center for Lung Research, Justus Liebig University Giessen, Giessen, Germany
,
Zulfugar Timur Taghiyev
1   Department of Cardiovascular Surgery, University Hospitals Giessen and Marburg Campus Giessen, Giessen, Germany
,
Matthias Schneider
3   Medical and Forensic Veterinary Clinic, Department of Small Animal Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
,
Andreas Böning
1   Department of Cardiovascular Surgery, University Hospitals Giessen and Marburg Campus Giessen, Giessen, Germany
4   Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Giessen, Germany
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Abstract

Objectives Clinical studies indicate encouraging cardioprotective potential for Cardioplexol. Its cardioprotective capacities during 45 minutes of ischemia compared with pure no-flow ischemia or during 90 minutes of ischemia compared with Calafiore cardioplegia were investigated experimentally.

Methods Forty-four rat hearts were isolated and inserted into a blood-perfused pressure-controlled Langendorff apparatus. In a first step, cardiac arrest was induced by Cardioplexol or pure no-flow ischemia lasting 45 minutes. In a second step, cardiac arrest was induced by Cardioplexol or Calafiore cardioplegia lasting 90 minutes. For both experimental steps, cardiac function, metabolic parameters, and troponin I levels were evaluated during 90 minutes of reperfusion. At the end of reperfusion, hearts were fixed, and ultrastructural integrity was examined by electron microscopy.

Results Step 1: after 90 minutes of reperfusion, hearts exposed to Cardioplexol had significantly higher left ventricular developed pressure (CP-45ˊ: 74%BL vs. no-flow-45ˊ: 45%BL; p = 0.046) and significantly better maximal left ventricular relaxation (CP-45ˊ: 84%BL vs. no-flow-45ˊ: 51%BL; p = 0.012). Oxygen consumption, lactate production, and troponin levels were similar in both groups. Step 2: left ventricular developed pressure was lower (22 vs. 48% of BL; p = 0.001) and coronary flow was lower (24 vs. 53% of BL; p = 0.002) when Cardioplexol was used compared with Calafiore cardioplegia. Troponin I levels were significantly higher under Cardioplexol (358.9 vs. 106.1 ng/mL; p = 0.016).

Conclusion Cardioplexol significantly improves functional recovery after 45 minutes of ischemia compared with pure ischemia. However, Cardioplexol protects the myocardium from ischemia/reperfusion-related damage after 90 minutes of ischemia worse than Calafiore cardioplegia.

Keywords

myocardial protection - crystalloid cardioplegia - ischemia and reperfusion - myocardial preservation - Cardioplexol - Calafiore

Presentation at Scientific Meetings

Preliminary results have been presented at the annual meeting of the DGTHG in February 2021. Additionally, results have been presented at the annual meeting of the DGTHG in February 2023.




Publication History

Received: 23 May 2023

Accepted: 10 July 2023

Article published online:
10 August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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