Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass
Background/Objectives: Previously, we showed that blood-based polarizing cardioplegia exerted beneficial cardioprotection during hypothermic ischemia; however, these positive effects of blood-based polarizing cardioplegia were reduced during normothermic ischemia compared to blood-based hyperkalemic...
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2024-12-01
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| author | David Santer Stefan Heber Anne-Margarethe Kramer Judith Radloff Katharina Heissl Attila Kiss David J. Chambers Seth Hallström Bruno K. Podesser |
| author_facet | David Santer Stefan Heber Anne-Margarethe Kramer Judith Radloff Katharina Heissl Attila Kiss David J. Chambers Seth Hallström Bruno K. Podesser |
| author_sort | David Santer |
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| description | Background/Objectives: Previously, we showed that blood-based polarizing cardioplegia exerted beneficial cardioprotection during hypothermic ischemia; however, these positive effects of blood-based polarizing cardioplegia were reduced during normothermic ischemia compared to blood-based hyperkalemic (depolarizing) cardioplegia. This study compares crystalloid polarizing cardioplegia to crystalloid depolarizing cardioplegia in a normothermic porcine model of cardiopulmonary bypass; Methods: Twelve pigs were randomized to receive either normothermic polarizing (<i>n</i> = 7) or depolarizing (<i>n</i> = 5) crystalloid cardioplegia. After the initiation of cardiopulmonary bypass, normothermic arrest (34 °C, 60 min) was followed by 60 min of on-pump and 90 min of off-pump reperfusion. Myocardial injury (arterial CK-MB), hemodynamic function, and the energy status of the hearts were measured; Results: The arterial release of CK-MB was comparable between groups (<i>p</i> = 0.78) during reperfusion. During 150 min of reperfusion, systolic left ventricular pressure (<i>p</i> = 0.01) and coronary flow (<i>p</i> = 0.009) were increased, and wedge pressure (<i>p</i> = 0.04) was decreased in the polarized group. Further hemodynamic parameters (cardiac output, stroke volume) and high-energy phosphate levels were similar between groups. The requirement for noradrenaline administration during reperfusion was significantly higher (<i>p</i> = 0.013) in the polarized group; Conclusions: Under normothermic conditions and despite a similar increase in levels of cardiac CK-MB, crystalloid polarizing cardioplegia protected systolic and diastolic cardiac function after 60 min of cardiac arrest. These results suggest beneficial effects for polarizing cardioplegia; clinical studies are required to confirm these effects. |
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| institution | Kabale University |
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| language | English |
| publishDate | 2024-12-01 |
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| series | Biomedicines |
| spelling | doaj-art-39073305d444468c9a01baab650a62192025-01-24T13:23:54ZengMDPI AGBiomedicines2227-90592024-12-011317010.3390/biomedicines13010070Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary BypassDavid Santer0Stefan Heber1Anne-Margarethe Kramer2Judith Radloff3Katharina Heissl4Attila Kiss5David J. Chambers6Seth Hallström7Bruno K. Podesser8Ludwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, AustriaInstitute of Physiology, Center for Physiology and Pharmacology, Medical University of Vienna, 1090 Vienna, AustriaLudwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, AustriaLudwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, AustriaLudwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, AustriaLudwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, AustriaCardiac Surgical Research, The Rayne Institute (King’s College London), Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, London SE1 7EH, UKDivision of Medicinal Chemistry Otto Loewi Research Center, Medical University of Graz, 8010 Graz, AustriaLudwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, AustriaBackground/Objectives: Previously, we showed that blood-based polarizing cardioplegia exerted beneficial cardioprotection during hypothermic ischemia; however, these positive effects of blood-based polarizing cardioplegia were reduced during normothermic ischemia compared to blood-based hyperkalemic (depolarizing) cardioplegia. This study compares crystalloid polarizing cardioplegia to crystalloid depolarizing cardioplegia in a normothermic porcine model of cardiopulmonary bypass; Methods: Twelve pigs were randomized to receive either normothermic polarizing (<i>n</i> = 7) or depolarizing (<i>n</i> = 5) crystalloid cardioplegia. After the initiation of cardiopulmonary bypass, normothermic arrest (34 °C, 60 min) was followed by 60 min of on-pump and 90 min of off-pump reperfusion. Myocardial injury (arterial CK-MB), hemodynamic function, and the energy status of the hearts were measured; Results: The arterial release of CK-MB was comparable between groups (<i>p</i> = 0.78) during reperfusion. During 150 min of reperfusion, systolic left ventricular pressure (<i>p</i> = 0.01) and coronary flow (<i>p</i> = 0.009) were increased, and wedge pressure (<i>p</i> = 0.04) was decreased in the polarized group. Further hemodynamic parameters (cardiac output, stroke volume) and high-energy phosphate levels were similar between groups. The requirement for noradrenaline administration during reperfusion was significantly higher (<i>p</i> = 0.013) in the polarized group; Conclusions: Under normothermic conditions and despite a similar increase in levels of cardiac CK-MB, crystalloid polarizing cardioplegia protected systolic and diastolic cardiac function after 60 min of cardiac arrest. These results suggest beneficial effects for polarizing cardioplegia; clinical studies are required to confirm these effects.https://www.mdpi.com/2227-9059/13/1/70cardioplegiapolarized arrestdepolarized arrestnormothermiaischemia-reperfusioncardioprotection |
| spellingShingle | David Santer Stefan Heber Anne-Margarethe Kramer Judith Radloff Katharina Heissl Attila Kiss David J. Chambers Seth Hallström Bruno K. Podesser Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass Biomedicines cardioplegia polarized arrest depolarized arrest normothermia ischemia-reperfusion cardioprotection |
| title | Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass |
| title_full | Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass |
| title_fullStr | Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass |
| title_full_unstemmed | Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass |
| title_short | Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass |
| title_sort | normothermic crystalloid polarizing cardioplegia improves systolic and diastolic function in a porcine model of cardiopulmonary bypass |
| topic | cardioplegia polarized arrest depolarized arrest normothermia ischemia-reperfusion cardioprotection |
| url | https://www.mdpi.com/2227-9059/13/1/70 |
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