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Ann Thorac Surg 1999;67:618-623
© 1999 The Society of Thoracic Surgeons
a Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania, USA
Accepted for publication July 23, 1998.
Address reprint requests to Dr Damiano, Section of Cardiovascular Surgery, Milton S. Hershey Medical Center, Pennsylvania State-Geisinger Health System, PO Box 850, Hershey, PA 17033
e-mail: rdamiano{at}psghs.edu
Background. 2,3-Butanedione monoxime (BDM) has been shown to possess cardioprotective properties related to the inhibition of cross-bridge force development, the reduction of myofilament Ca2+ sensitivity, and the attenuation of intracellular Ca2+ transients. This study tested the hypothesis that cardiac arrest achieved with BDM would be as effective as that achieved with St. Thomas’ solution (StT).
Methods. Isolated rabbit hearts, studied on a blood-perfused Langendorff column, underwent 1 hour of ischemia (37°C) and 30 minutes of reperfusion. Cardioplegia was administered every 20 minutes in the form of (1) Krebs-Henseleit solution only (control), (2) 20 mmol/L of BDM, or (3) StT. Recovery of developed pressure, atrioventricular activation times, and tissue water content were measured.
Results. Recovery of developed pressure for the control, BDM, and StT groups was 44% ± 3% (p < 0.05 versus BDM and StT), 57% ± 5%, and 62% ± 4%, respectively. Atrioventricular activation times were significantly prolonged in the control group (42 ± 15 ms, p = 0.042) and the StT group (26 ± 9 ms, p = 0.034), but not in the BDM group (14 ± 8 ms). Tissue water content after reperfusion was 80% ± 0.4%, 80% ± 0.2%, and 76% ± 1.0% (p < 0.05 versus control) in the control, StT, and BDM groups, respectively.
Conclusions. 2,3-Butanedione monoxime was as effective as StT in protecting the myocardium. Unlike StT, BDM ameliorated myocardial edema and atrioventricular conduction delay after reperfusion.
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