[The effect of continuous perfusion with St. Thomas' Hospital cardioplegic solution containing glucose, insulin and L-aspartate on functional recovery after myocardial preservation in the rat].
The aim of this study was to determine the effect of the continuous perfusion with St. Thomas' Hospital cardioplegic solution (ST solution) containing glucose, insulin and L-aspartate upon post-preservation recovery of cardiac function in the isolated rat heart.


METHODS
Hearts from Wistar male rats were perfused with Krebs-Henseleit bicarbonate buffer (KHBB) solution and cardiac function was measured using an isolated working heart preparation. Hearts were then preserved by continuous perfusion, (1) with ST solution or ST solution containing L-aspartate (20 mmol/L9 at 20 degrees C and 4 degrees C for 12 hours, (2) with ST solution containing L-aspartate at 4 degrees C for 24 hours, (3) with ST solution containing glucose (9 mmol/L) and insulin (10 U/L solution) or ST solution containing glucose, insulin and L-aspartate at 20 degrees C for 24 hours. This was followed by 15 minutes of Langendorff perfusion and 20 minutes of working perfusion with KHBB solution. During the working perfusion in the post-preservation period, cardiac function was remeasured.


RESULTS
(1) At 20 degrees C, percent recovery of cardiac output (%CO) was 57.7 +/- 3.8% and 79.9 +/- 1.4*% in the L-aspartate-free group and the L-aspartate-containing group, respectively (*p < 0.05). At 4 degrees C, %CO was 74.4 +/- 2.2% and 80.5 +/- 1.7% in the L-aspartate-free group and the L-aspartate-containing group, respectively (NS). (2) %CO in L-aspartate-containing group at 4 degrees C decreased to 46.8 +/- 2.4% when preservation time was extended to 24-hours from 12 hours. (3) On the other hands, the addition of L-aspartate to the ST solution containing glucose and insulin resulted in an additive protection and %CO was 76.0 +/- 1.1% even after 24 hour preservation at 20 degrees C.


CONCLUSIONS
Our results indicate that L-aspartate as an additive to perfusion medium might be beneficial for myocardial preservation, and that at 20 degrees C, the addition of L-aspartate to the ST solution containing glucose and insulin could improve the post-preservation recovery after the 24-hour preservation.
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Y
Y
Shimada
F
F
Yamamoto
H
H
Yamamoto
Y
Y
Kumada
K
K
Kagisaki
T
T
Ishikawa
T
T
Oka
Y
Y
Kawashima
D000818:Animals; D001224:Aspartic Acid / Q000008:administration & dosage*; D001639:Bicarbonates; D002122:Calcium Chloride; D002314:Cardioplegic Solutions; D005947:Glucose / Q000008:administration & dosage*; D006321:Heart / Q000502:physiology; D066298:In Vitro Techniques; D007328:Insulin / Q000008:administration & dosage*; D008274:Magnesium; D008297:Male; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000379:methods*; D011189:Potassium Chloride; D051381:Rats; D017208:Rats, Wistar; D012965:Sodium Chloride; D013997:Time Factors
D001639:Bicarbonates; D002314:Cardioplegic Solutions; D007328:Insulin; C041711:St. Thomas' Hospital cardioplegic solution; D001224:Aspartic Acid; D012965:Sodium Chloride; D011189:Potassium Chloride; D008274:Magnesium; D005947:Glucose; D002122:Calcium Chloride