Protective effects of cardioplegia on diastolic function of hypertrophied rat hearts after hypothermic ischaemic arrest

Academic Article

Abstract

  • This study was undertaken to assess the effects of hypothermia and chemical cardioplegia on the functional recovery of hypertrophied non-failing rat hearts subjected to an extended period of global ischaemia. Left ventricular hypertrophy was produced by constriction of the abdominal aorta. Hearts were studied an average of 8 weeks following this procedure. Sham-operated animals served as controls. Twenty-nine isolated isovolumic perfused rat heart preparations were then subjected to 2 h of ischaemic arrest at 15-18° C followed by 45 min of normothermic reperfusion. In one series of hearts (8 sham, 8 hypertrophied), myocardial protection consisted of hypothermia alone. In another series (6 sham, 7 hypertrophied), repeated infusions of cardioplegic solution at 30-min intervals throughout arrest were added to hypothermia. Hypothermia alone resulted in a similar preservation of contractility as evidenced by the recovery of dp/dt(max) left ventricular (LV) systolic pressure after 45 min of reperfusion (91.6 ± 5.9% of control values in sham vs 78.6 ± 6.5% in hypertrophied hearts). Conversely, the recovery of compliance was much more impaired in hypertrophied hearts as indicated by a significantly higher percentage of increase in post-ischaemic LV diastolic pressure (DP) (at 45 min of reperfusion: 243.8 ± 27.5% of control values vs 167.1 ± 23.8% in sham, P < 0.05). The addition of cardioplegia improved the preservation of contractility in both groups but its major effect was to normalize the recovery of compliance in hypertrophied hearts so that post-ischaemic LVDP values were no longer different from those recorded in normal hearts (at 45 min of reperfusion: 102.1 ± 32.8% vs 98.5 ± 14.2% of pre-ischaemic values respectively). These results suggest that the increased susceptibility of the hypertrophied LV to ischaemic injury is primarily due to an impairment of diastolic function which can be prevented by an adequately formulated cardioplegic solution.
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    Digital Object Identifier (doi)

    Author List

  • Grousset C; Menasche P; Apstein CS; Mouas C; Marotte F; Piwnica A
  • Start Page

  • 347
  • End Page

  • 353
  • Volume

  • 5
  • Issue

  • SUPPL. F