title: Cardiomyocyte apoptosis after cardioplegic ischemia: comparison to unprotected regional ischemia-reperfusion.
abstract: BACKGROUND
  Cardiomyocyte apoptosis might contribute to left ventricular (LV) dysfunction following cardiac surgery. Magnetic resonance imaging is considered the most accurate method of determining LV function. We compared apoptosis (by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, TUNEL, staining and detection of caspase 3 activation) and LV function after regional ischemia-reperfusion (I-R) and global cardioplegic ischemia.
  
  
  METHODS
  Pigs were randomized to undergo regional myocardial I-R for 20 + 20 min, global myocardial ischemia with cardiopulmonary bypass (CPB) for 40 min or CPB without ischemia (control), followed by 274 min of reperfusion.
  
  
  RESULTS
  Compared with the control group, the number of TUNEL-positive cardiomyocytes was higher in the global ischemia group with CPB (0.024 ± 0.014%; p = 0.02) and further increased in areas of unprotected regional I-R (0.444 ± 0.562%; p = 0.003, vs. control). Myocytes with active caspase 3 were detected after global and regional ischemia. The global ejection fraction did not differ between CPB and regional I-R groups.
  
  
  CONCLUSIONS
  The use of cardioplegia and CPB efficiently protects the heart from global I-R-induced cardiomyocyte apoptosis during open heart surgery.
authors.affiliation: Department of Surgery, Turku University Hospital, Turku, Finland. markus.malmberg@utu.fi
authors.forename: M
authors.initials: M
authors.lastname: Malmberg
authors.forename: J
authors.initials: J
authors.lastname: Parkka
authors.forename: T
authors.initials: T
authors.lastname: Vahasilta
authors.forename: A
authors.initials: A
authors.lastname: Saraste
authors.forename: T
authors.initials: T
authors.lastname: Laitio
authors.forename: J
authors.initials: J
authors.lastname: Kiss
authors.forename: J
authors.initials: J
authors.lastname: Latva-Hirvela
authors.forename: P
authors.initials: P
authors.lastname: Saukko
authors.forename: T
authors.initials: T
authors.lastname: Savunen
mesh_terms: D000818:Animals; D017209:Apoptosis; D053148:Caspase 3 / Q000378:metabolism; D006324:Heart Arrest, Induced / Q000009:adverse effects*; D006439:Hemodynamics; D020287:In Situ Nick-End Labeling; D008279:Magnetic Resonance Imaging; D015425:Myocardial Reperfusion / Q000009:adverse effects*; D015428:Myocardial Reperfusion Injury / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D032383:Myocytes, Cardiac / Q000473:pathology*; D011897:Random Allocation; D013552:Swine; D016277:Ventricular Function, Left
chemical_list: D053148:Caspase 3