Adding Emulsified Isoflurane to Cardioplegia Solution Produces Cardiac Protection in a Dog Cardiopulmonary Bypass Model.
This study investigated whether caridoplegia solution with Emulsified Isoflurane (EI) could improve cardiaoprotection in a dog CPB model of great similarity to clinical settings. Adult dogs were randomly assigned to receive one of the following cardioplegia solutions: St. Thomas with EI (group ST+EI), St. Thomas with 30% Intralipid (group ST+EL) and St. Thomas alone (group ST). The aorta was cross-clamped for two hours followed by reperfusion for another two hours, during which cardiac output was measured and dosages of positive inotropic agent to maintain normal hemodynamics were recorded. Serum level of cardiac troponin I (cTnI) and CK-MB were measured. Deletion of cardiac mitochondrial DNA was examined at the end of reperfusion. Compared with ST, ST+EI decreased the requirement of dopamine support while animals receiving ST+EI had a significantly larger cardiac output. ST+EI reduced post-CPB release of cTnI and CK-MB. Mitochondrial DNA loss was observed in only one of the tested animals from group ST+EI while it was seen in all the tested animals from group ST+EL and ST. Addition of emulsified isoflurane into cardioplegia solution protects against myocardial ischemia reperfusion injury. This protective effect might be mediated by preserving mitochondrial ultrastructure and DNA integrity.
Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China.
Han
H
Huang
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Cheng
C
Zhou
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Jin
J
Liu
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Haibo
H
Song
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Yan
Y
Qiu
D000818:Animals; D002314:Cardioplegic Solutions / Q000008:administration & dosage / Q000737:chemistry*; D002315:Cardiopulmonary Bypass; D052279:Creatine Kinase, MB Form / Q000097:blood; D004272:DNA, Mitochondrial / Q000378:metabolism; D004195:Disease Models, Animal; D004285:Dogs; D004655:Emulsions / Q000737:chemistry; D006324:Heart Arrest, Induced; D006352:Heart Ventricles / Q000473:pathology; D007530:Isoflurane / Q000008:administration & dosage* / Q000737:chemistry; D008297:Male; D008928:Mitochondria / Q000235:genetics / Q000378:metabolism / Q000648:ultrastructure; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism; D018384:Oxidative Stress; D010743:Phospholipids / Q000737:chemistry; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D013024:Soybean Oil / Q000737:chemistry; D013482:Superoxide Dismutase / Q000032:analysis; D019210:Troponin I / Q000097:blood; D051028:bcl-2-Associated X Protein / Q000378:metabolism
D002314:Cardioplegic Solutions; D004272:DNA, Mitochondrial; D004655:Emulsions; D010743:Phospholipids; D019253:Proto-Oncogene Proteins c-bcl-2; D019210:Troponin I; D051028:bcl-2-Associated X Protein; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D007530:Isoflurane; D013482:Superoxide Dismutase; D052279:Creatine Kinase, MB Form