Pressure volume curves in arrested heterotopic rat heart isografts: role of improved myocardial protection.
BACKGROUND
To minimize decreases in left ventricular (LV) compliance immediately after rat heart transplantation, we tested several different methods of myocardial protection.


METHODS
Five groups of ACI rat hearts (n = 6 each) were arrested by coronary perfusion with 5 ml of UW (University of Wisconsin), UW-BDM (UW with 2,3-butanedione monoxime), CU (Columbia University), or CU-BDM solution or by LV injection of potassium chloride and Ringer's lactate immersion (KCl/RL). After abdominal isografting and blood reperfusion for 15 min, transplanted hearts (TxH) were arrested and excised. Diastolic LV pressure-volume curves (LVPVCs) were correlated with myocardial water content (MWC). Native hearts (NH) were arrested identically to TxH and maintained at 4 degrees C by immersion. LVPVCs were measured at 15-min intervals for 90 min.


RESULTS
In three of four pressure intervals at Time 0, normalized LV volume (LVV) was smaller (P < 0.05, ANOVA) in KCl/RL native hearts than in the four perfusion groups. LVV decreased significantly in NH after 45-75 min; LVV decreased similarly with time in all groups. In TxH, postarrest LVVs were higher with UW-BDM, CU-BDM, and CU than with UW or KCl/RL (P < 0.05, ANOVA). Expressing LVV of TxH as a percentage of NH, UW-BDM, CU, and CU-BDM provided qualitatively better diastolic properties than KCl/RL and UW.


CONCLUSIONS
Thus rat LVPVCs can be improved after heart transplantation with alternative strategies of myocardial protection. KCl arrest decreases LV filling volume in this model and should be avoided.
Starr
J P
JP
Department of Surgery, Columbia University College of Physicians & Surgeons, New York, New York 10032, USA.
Jia
C X
CX
Rabkin
D G
DG
Amirhamzeh
M M
MM
Hart
J P
JP
Hsu
D T
DT
Soto
P
P
Pinsky
D
D
Spotnitz
H M
HM
D000005:Abdomen / Q000601:surgery; D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D001794:Blood Pressure; D001810:Blood Volume; D003931:Diacetyl / Q000031:analogs & derivatives / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D006324:Heart Arrest, Induced; D016027:Heart Transplantation; D007328:Insulin / Q000494:pharmacology; D007552:Isotonic Solutions / Q000494:pharmacology; D015425:Myocardial Reperfusion; D019188:Organ Preservation Solutions / Q000494:pharmacology; D011189:Potassium Chloride / Q000494:pharmacology; D011887:Raffinose / Q000494:pharmacology; D051381:Rats; D011912:Rats, Inbred ACI; D000077325:Ringer's Lactate; D016042:Transplantation, Heterotopic; D016277:Ventricular Function, Left / Q000187:drug effects
D007328:Insulin; D007552:Isotonic Solutions; D019188:Organ Preservation Solutions; D000077325:Ringer's Lactate; C055206:University of Wisconsin-lactobionate solution; C004717:diacetylmonoxime; D000493:Allopurinol; D011189:Potassium Chloride; D005978:Glutathione; D003931:Diacetyl; D000241:Adenosine; D011887:Raffinose