title: Evidence for the role of neutrophils in reperfusion injury after cold cardioplegic ischemia in neonatal lambs.
abstract: The role of neutrophils in reperfusion injury after hypothermic, cardioplegia-protected ischemia is incompletely understood but may involve neutrophil-endothelial interactions. We examined 33 isolated blood-perfused neonatal lamb hearts arrested for 2 hours with 15 degrees C potassium cardioplegic solution and reperfused with unmodified blood (group C, n = 9), with neutrophil-depleted (Sepacell filter) blood (group ND, n = 9), with the addition of CV-3988, a platelet-activating factor antagonist, to the perfusate (group NA, n = 9), and with neutrophil-depleted blood plus CV-3988 (group ND/NA, n = 6). The percent recovery of isovolumic left ventricular developed pressure at a fixed balloon volume at 30 minutes after reperfusion in groups ND (84.8% +/- 11.8%, mean +/- standard deviation), NA (89.9% +/- 11.5%), and ND/NA (87.8% +/- 6.4%) were higher than in group C (73.1% +/- 7.9%) (p less than 0.05). Groups NA (105.5% +/- 13.7%) and ND/NA (108.0% +/- 11.2%) achieved higher percent recovery of coronary blood flow than group C (84.4% +/- 10.4%) (p less than 0.05). In each heart, we also tested coronary vascular resistance response to infusion of acetylcholine 10(-6) mol/L to assess endothelial function. Percent recovery of coronary vascular resistance response to acetylcholine was higher in groups ND (56.8% +/- 31.4%), NA (56.3% +/- 17.3%), and ND/NA (58.7% +/- 24.8%) than in group C (13.3% +/- 38.3%) (p less than 0.05). These results show that, after ischemia/reperfusion, groups ND, NA, and ND/NA had better recovery of both mechanical and endothelial function than group C. The parallel changes in recovery of mechanical and endothelial function suggest that neutrophil-endothelial interactions may be a significant factor in reperfusion injury.
authors.affiliation: Department of Cardiovascular Surgery, Children's Hospital, Boston, Mass. 02115.
authors.forename: H
authors.initials: H
authors.lastname: Kawata
authors.forename: K
authors.initials: K
authors.lastname: Sawatari
authors.forename: J E
authors.initials: JE
authors.lastname: Mayer
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000818:Animals; D000831:Animals, Newborn / Q000502:physiology*; D002314:Cardioplegic Solutions; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006324:Heart Arrest, Induced / Q000379:methods*; D015428:Myocardial Reperfusion Injury / Q000209:etiology* / Q000503:physiopathology; D009504:Neutrophils / Q000502:physiology*; D010742:Phospholipid Ethers / Q000494:pharmacology; D010972:Platelet Activating Factor / Q000037:antagonists & inhibitors; D012756:Sheep; D013997:Time Factors; D014655:Vascular Resistance / Q000502:physiology
chemical_list: D002314:Cardioplegic Solutions; D010742:Phospholipid Ethers; D010972:Platelet Activating Factor; C037913:CV 3988; D000109:Acetylcholine