优化心脏移植物保存：一项使用磷-31磁共振波谱和生化分析的对比实验研究。

Optimized cardiac graft preservation: a comparative experimental study using P-31 magnetic resonance spectroscopy and biochemical analyses.

作者信息

Bernard M, Caus T, Sciaky M, Lan C, Cozzone P J

机构信息

Centre de Résonance Magnétique Biologique et Médicale, UMR CNRS 6612, Faculté de Médecine, Marseille, France.

出版信息

J Heart Lung Transplant. 1999 Jun;18(6):572-81. doi: 10.1016/s1053-2498(98)00046-1.

DOI:10.1016/s1053-2498(98)00046-1

PMID:10395355

Abstract

BACKGROUND

The University of Wisconsin (UW), St. Thomas (ST) and Broussais (B) solutions were compared to the CRMBM solution, that we developed for long term heart preservation.

METHODS

Isolated isovolumic rat hearts were arrested with each cardioplegic solution (n = 5) to 8 hearts in each group), submitted to 12 hours of cold storage (4 degrees C) in the same solution and then reperfused for 60 minutes at 37 degrees C. Function was measured during control and reflow. High energy phosphates and intracellular pH were monitored by P-31 magnetic resonance spectroscopy. Analyses were performed by biochemical assays and HPLC in coronary effluents (CK, Pi, lactate, purines) and in freeze-clamped hearts (amino acids, nucleotides, CK, LDH) at the end of reperfusion.

RESULTS

Functional recovery was significantly improved with the new cardioplegic solution (50+/-12% recovery for the rate pressure product at the end of reflow vs 8+/-3% with UW, 0% with B and with ST). This result was correlated with the best metabolic and cellular protection as assessed in particular by higher PCr levels during reflow (30+/-3% vs 10+/-3% with UW, 8+/-4% with B, and 7+/-1% with ST) as well as reduced creatine kinase leakage during reflow (110+/-15 IU/60 minute vs 270 +/- 57 IU/60 minute with UW, 323+/-36 IU/60 minute with Broussais solution and 237+/-18 IU/60 minute with ST).

CONCLUSION

This new solution is more effective in prolonged myocardial protection than the three most widely used solutions.

摘要

背景

将威斯康星大学（UW）溶液、圣托马斯（ST）溶液和布鲁赛（B）溶液与我们研发的用于长期心脏保存的CRMBM溶液进行比较。

方法

用每种心脏停搏液使离体等容大鼠心脏停搏（每组n = 5，每组8颗心脏），在相同溶液中于4℃冷藏12小时，然后在37℃再灌注60分钟。在对照期和再灌注期测量心脏功能。通过磷-31磁共振波谱监测高能磷酸盐和细胞内pH。再灌注结束时，通过生化分析和高效液相色谱法分析冠状动脉流出液（肌酸激酶、无机磷、乳酸、嘌呤）以及冷冻钳夹心脏组织（氨基酸、核苷酸、肌酸激酶、乳酸脱氢酶）。

结果

新的心脏停搏液显著改善了心脏功能恢复情况（再灌注结束时心率血压乘积恢复率为50±12%，而UW溶液组为8±3%，B溶液组和ST溶液组为0%）。这一结果与最佳的代谢和细胞保护相关，特别是通过再灌注期间较高的磷酸肌酸水平（30±3%，而UW溶液组为10±3%，B溶液组为8±4%，ST溶液组为7±1%）以及再灌注期间肌酸激酶泄漏减少（110±15 IU/60分钟，而UW溶液组为270±57 IU/60分钟，布鲁赛溶液组为323±36 IU/60分钟，ST溶液组为237±18 IU/60分钟）得以体现。