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The Annals of Thoracic Surgery, Vol 58, 1481-1485, Copyright © 1994 by The Society of Thoracic Surgeons
RW Illes, JK Wright, K Inners-McBride, CJ Yang and A Tristan
Ischemic preconditioning has not been investigated in a clinically relevant
model of hypothermic multidose cardioplegia arrest. Using isolated rabbit
hearts perfused on a Langendorff apparatus, ischemic preconditioning was
investigated as an adjunct to crystalloid cardioplegia during a 2.5-hour
ischemic period at 15 degrees C. After baseline functional data were
obtained, ischemic preconditioning was induced with either 1 minute or 5
minutes of normothermic ischemia, followed by 5 minutes of reperfusion
before the arrest period. Control hearts underwent no ischemic
preconditioning. The control hearts exhibited a decrement in both the peak
developed pressure and diastolic function, as measured by the slope of the
diastolic pressure-volume relationship, of from 107 +/- 2 to 68 +/- 7 mm Hg
(p < 0.005) and from 0.99 +/- 0.2 to 2.95 +/- 0.44 mm Hg/0.1 mL (p <
0.005), respectively. Hearts exposed to either 1 or 5 minutes of
normothermic ischemia showed no significant change in the slope of the
diastolic pressure-volume relationship. Hearts exposed to 1 or 5 minutes of
normothermic ischemia also had a significant decrease in the peak developed
pressure of from 107 +/- 6 to 92 +/- 2 mm Hg and from 102 +/- 3 to 85 +/- 4
mm Hg, respectively (p < 0.05). However, ischemic preconditioning
brought about a significant improvement in the postischemic peak developed
pressure, as opposed to that seen for the control hearts (p < 0.05).
Creatine kinase washout was significantly higher in the control hearts
only. High-energy phosphate levels, lactate levels, the percentage wet
weight, and tissue creatine phosphate levels were not significantly
different among the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Ischemic preconditioning improves preservation with crystalloid cardioplegia
Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston 77550-0528.
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