title: Comparative analysis of the performance of various crystalloid cardioplegic solutions on myocardial protection after prolonged cold ischemia.
abstract: BACKGROUND
  The quality and effectiveness of myocardial protection are fundamental problems to expand the use of and consequently good outcomes of donated hearts for transplantation.
  
  
  OBJECTIVE
  The purpose of this investigation was to compare the cardioprotective effects of Krebs-Henseleit, Bretschneider-HTK, St Thomas, and Celsior solutions using a modified nonrecirculating Langendorff column model of isolated perfused rat heart during prolonged cold storage.
  
  
  METHODS
  After removal 36 rat hearts underwent isolated perfusion into a Langendorff apparatus using Krebs-Henseleit solution for a 15-minute period of recovery; we excluded organs that did not maintain an aortic pressure above 100 m Hg. Subsequently, we equally distributed the hearts into four groups according to the cardioprotection solution; group 1, Krebs-Henseleit (control); group II, Bretschneider-HTK; group III, St Thomas; and group IV, Celsior. Each heart received the specific cardioplegic solution at 10°C for 2-hour storage at 20°C, before a 15 minutes perfusion with Krebs-Henseleit solution for recovery and stabilization. After 60 additional minutes of perfusion, every 5 minutes we determined heart rate (HR), coronary flow (CF), left ventricular systolic pressure (LVSP), and positive and negative peak of the first derivative of left ventricular pressure (+dP/dt and -dP/dt, respectively).
  
  
  RESULTS
  Comparative analysis by Turkey's test showed the following performances among the groups at 60 minutes of reperfusion: HR: II = IV > III > I; CF: II = IV > I = III; LVSP: IV > I = II = III; +dP/dt: IV > I = II = III; and -dP/dt: IV = II > I = II.
  
  
  CONCLUSIONS
  Cardioprotective solutions generally used in clinical practice are not able to avoid hemodynamic alterations in hearts exposed to prolonged ischemia. Celsior solution showed better performance than Bretschneider-HTK, St Thomas, and Krebs-Henseleit.
authors.affiliation: Laboratory of the Sao Francisco Assis Foundation, Belo Horizonte, Brazil.
authors.forename: M L
authors.initials: ML
authors.lastname: Lima
authors.forename: A I
authors.initials: AI
authors.lastname: Fiorelli
authors.forename: O M
authors.initials: OM
authors.lastname: Gomes
authors.forename: B B
authors.initials: BB
authors.lastname: Pinheiro
authors.forename: M A F
authors.initials: MA
authors.lastname: Da Silva
authors.forename: L A B J
authors.initials: LA
authors.lastname: Porto
authors.forename: L
authors.initials: L
authors.lastname: Novaes
authors.forename: N A G
authors.initials: NA
authors.lastname: Stolf
authors.forename: D R
authors.initials: DR
authors.lastname: Souza
mesh_terms: D000818:Animals; D002314:Cardioplegic Solutions; D016022:Case-Control Studies; D003080:Cold Temperature; D008297:Male; D017202:Myocardial Ischemia / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar
chemical_list: D002314:Cardioplegic Solutions