Deleterious Effect of Hypothermia in Myocardial Protection Against Cold Ischemia: A Comparative Study in Isolated Rat Hearts

Lima, Melchior Luiz; Fiorelli, Andrea; Vassallo, Dalton Valentim; Batista, Priscila Rossi de; Simões, Fabiana Vieira; Fiorim, Jonaína; Stefanon, Ivanita; Pinheiro, Bruno Botelho; Stolf, Noedir Antônio Groppo; Gomes, Otoni Moreira

doi:10.1016/j.transproceed.2012.07.007

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…Thus, adequate myocardial preservation is a critical measure to ensure the viability of the heart in procedures performed with prolonged ischemic time [ 12 ] . Temperature reduction is frequently used for such purpose [ 13 ] but so far there is no gold standard for myocardial protection [ 14 ] . Hypothermia is a standard strategy and, according to Cleveland et al [ 15 ] , is the most important factor in myocardial protection.…”

Section: Discussionmentioning

confidence: 99%

Cardioprotective Solutions Exposure For 1 Hour in Hypoxia and Low Temperatures Affects Vascular Reactivity Differently

Batista¹,

Vassallo²,

Lima³

2021

Braz J Cardiovasc Surg

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Introduction Heart preservation benefits cardiac performance after operations decreasing morbidity but the contribution of the vascular reactivity has been neglected. Objective We evaluated whether cardioprotective solutions, Krebs-Henseleit (KH), Bretschneider-HTK (BHTK), St. Thomas No. 1 (STH-1), and Celsior (CEL), affect vascular reactivity. Methods Aortic rings from Wistar rats were used in two protocols. First, the rings were exposed to BHTK, STH-1 or CEL for 1 hour of hypoxia at 37 °C. Second, the rings were exposed to 10 °C or 20 °C for 1 hour under hypoxia. After treatment, the rings were immersed in KH at 37 °C, endothelial integrity was tested and concentration-response curves to phenylephrine were performed. Results In the first protocol, the solutions did not damage the endothelium; CEL and BHTK reduced KCl-induced contractions but not STH-1; only CEL and BHTK reduced vascular reactivity; there was a positive correlation between R max and KCl concentration. At 20 °C, 1 hour under hypoxia, the solutions produced similar KCl-induced contractions without endothelial damage. CEL, BHTK and STH-1 decreased vascular reactivity. At 10 °C, STH-1 increased reactivity but CEL and BHTK decreased. After 1 hour under hypoxia in CEL or BHTK solutions, reactivity was similar at different temperatures. At 20 °C, endothelial damage after exposure to STH-1 produced more vasoconstriction than CEL and BHTK. However, at 10 °C, endothelial damage after CEL and BHTK exposure elicited more vasoconstriction while STH-1 showed a small vasoconstrictor response, suggesting endothelial damage. Conclusion STH-1 decreased reactivity at 20 °C and increased at 10 °C. CEL promoted greater endothelial modulation at 10 °C than at 20 °C, while STH-1 promoted higher modulation at 20 °C than at 10 °C. Vascular tone was reduced by CEL and BHTK exposure, also depending on the KCl concentration.

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Section: Discussionmentioning

confidence: 99%

Cardioprotective Solutions Exposure For 1 Hour in Hypoxia and Low Temperatures Affects Vascular Reactivity Differently

Batista¹,

Vassallo²,

Lima³

2021

Braz J Cardiovasc Surg

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“…During cold ischemic preservation, the low temperature reduces the intracellular enzymatic activity and decreases the metabolic rate for myocardial protection; however, the presence of myocardial edema, acidosis, metabolic substrate failure, endothelial damage, and myocardial apoptosis remains. 1,2 To overcome these complications, studies to optimize the preservation solution have been carried out. For example, as an intracellular-type solution, Celsior solution has certain advantages for heart preservation.…”

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confidence: 99%

Comparative Analysis of Preservation Method and Intermittent Perfusion Volume on the Expression of Endothelial and Inflammatory Markers by Coronal Artery and Myocardium in Porcine Donor Hearts

Zhou

Wang

et al. 2014

ASAIO Journal

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Although continuous perfusion of donor hearts for preservation during transportation has been widely applied, intermittent perfusion has been suggested as an alternative. The aim of this study was to identify the optimal intermittent perfusion protocol by investigating the effects of perfusion volume on endothelial and inflammatory marker expression by the coronary artery. Donor porcine hearts were perfused with various volumes of Celsior solution supplemented with diazoxide (50, 100, 150, 200, and 250 ml) every 2 h for 30 min each for a 10 h period. The effects on cardiomyocytes and vascular endothelial cell morphology and marker expression were compared to the immersion control group. Whereas an incomplete endothelial cell layer with disorganized connective tissue was observed in the control and 50, 100, and 150 ml intermittent perfusion groups, transmission electron microscopic analysis revealed a complete endothelial cell layer in the intima with an organized subendothelium. A perfusion volume-dependent increase in eNOS expression that coincided with a decrease in ET-1, ICAM-1, vWF, and P-selectin expression was detected (all p < 0.01). Intermittent perfusion with 200 ml of Celsior solution every 2 h conferred protective effects simultaneously to the coronary arteries and myocardium on the porcine donor heart over a clinically relevant preservation period.

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Preservation of the donor heart: from basic science to clinical studies

Минасян

Galagudza

Dmitriev

et al. 2014

Interact CardioVasc Thorac Surg

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The methods of donor heart preservation are aimed at minimizing graft dysfunction caused by ischaemia-reperfusion injury (IRI) which inevitably occurs during the ex vivo transport interval. At present, the standard technique of heart preservation is cardiac arrest followed by static cold storage in a crystalloid heart preservation solution (HPS). This technique ensures an acceptable level of heart protection against IRI for <6 h. In clinical trials, comparable levels of myocardial protection against IRI were provided by various HPSs. The growing shortage of donor hearts is one of the major factors stimulating the development of new techniques of heart preservation. Here, we summarize new HPS formulations and provide a focus for optimization of the composition of existing HPSs. Such methods of donor heart preservation as machine perfusion, preservation at sub-zero temperature and oxygen persufflation are also discussed. Furthermore, we review experimental data showing that pre- and post-conditioning of the cardiac graft can improve its function when used in combination with cold storage. The evidence on the feasibility of cardiac donation after circulatory death, as well as the techniques of heart reconditioning after a period of warm ischaemia, is presented. The implementation of new techniques of donor heart preservation may contribute to the use of hearts from extended criteria donors, thereby expanding the total donor pool.

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Deleterious Effect of Hypothermia in Myocardial Protection Against Cold Ischemia: A Comparative Study in Isolated Rat Hearts

Cited by 3 publications

References 13 publications

Cardioprotective Solutions Exposure For 1 Hour in Hypoxia and Low Temperatures Affects Vascular Reactivity Differently

Cardioprotective Solutions Exposure For 1 Hour in Hypoxia and Low Temperatures Affects Vascular Reactivity Differently

Comparative Analysis of Preservation Method and Intermittent Perfusion Volume on the Expression of Endothelial and Inflammatory Markers by Coronal Artery and Myocardium in Porcine Donor Hearts

Preservation of the donor heart: from basic science to clinical studies

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