Comparison of effects of total enteral versus total parenteral nutrition on ischemia/reperfusion-induced heart injury in rats.
BACKGROUND
The long-term effect of nutrition on cardiac function remains to be elucidated. One possible link is the newly discovered gastric hormone ghrelin, which has been reported to be cardioprotective.


OBJECTIVE
The present study examined whether total enteral nutrition (TEN) and total parenteral nutrition (TPN) differ in their modulation of ghrelin production and their effects on cardiac function after ischemia/reperfusion injury.


METHODS
Rats received isocaloric parenteral or enteral nutrition through implanted vascular catheters or gastrostomy tubes. TEN was administered in a conventional (TEN-C) or immunonutrition (TEN-I) form. After 7 days, serum ghrelin levels were determined by enzyme-linked immunosorbent assays and myocardial function was assessed using the Langendorff isolated heart technique.


RESULTS
TEN-I animals had significantly higher plasma ghrelin levels than the other groups. After ischemia/reperfusion injury, left ventricular developed pressure decreased in animals receiving TPN when compared to animals receiving TEN-I. Animals receiving TPN also had significant reductions in their maximal rates of increase and decrease in left ventricular pressure when compared to animals receiving TEN-I (unpaired t test, p < 0.05).


CONCLUSIONS
TEN-I increases serum levels of ghrelin, which protects cardiac function after ischemic/reperfusion injury. Because TEN-I more effectively protects cardiac function, we recommend it for long-term nutritional support.
Hagiwara
S
S
Anesthesiology, Department of Brain and Nerve Science, Oita University Faculty of Medicine, Oita, Japan. saku@med.oita-u.ac.jp
Iwasaka
H
H
Shingu
C
C
Noguchi
T
T
D000818:Animals; D004750:Enteral Nutrition; D054439:Ghrelin / Q000097:blood* / Q000378:metabolism; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism; D006321:Heart / Q000502:physiology*; D006334:Heart Function Tests; D008297:Male; D015428:Myocardial Reperfusion Injury; D009206:Myocardium / Q000378:metabolism; D010289:Parenteral Nutrition, Total; D051381:Rats; D017208:Rats, Wistar
D054439:Ghrelin; D018840:HSP70 Heat-Shock Proteins