Choong Y S, Gavin J B
Department of Pathology, University of Auckland School of Medicine, New Zealand.
J Heart Lung Transplant. 1991 Jul-Aug;10(4):537-46.
There are conflicting reports of the beneficial effects of University of Wisconsin (UW) cardioplegic solution used in heart preservation techniques. Therefore we investigated the efficacy of myocardial protection in adult rat hearts subjected to single-dose infusion (3 minutes) of nonoxygenated cardioplegic solutions (UW or St. Thomas' Hospital solution No. 2 [STH]) and stored at 4 degrees C by immersion in the same solution or in saline solution. Isolated working-heart preparations (n = 8 per group) were used to assess the prearrest (20 minutes' normothermic perfusion) and postischemic left ventricular functions. Four groups of hearts underwent 5, 8, 10, and 20 hours of cold ischemia (4 degrees C) in UW solution. Hearts stored for 8 to 20 hours showed no postischemic recovery of cardiac pump function (aortic flow, 0%), had decreased levels of myocardial high-energy phosphates, and were highly edematous (50% to 70% increased). After 5 hours of storage there was also poor recovery of aortic flow, coronary flow, and aortic pressure (55.0% +/- 19.4%, 67.1% +/- 5.1%, and 58.1% +/- 11.7%, respectively) but good recovery of adenosine triphosphate, creatine phosphate, and guanosine triphosphate (18.54 +/- 1.42, 29.99 +/- 2.05, and 1.64 +/- 0.14 mumol/gm dry weight, respectively). In contrast, hearts arrested and stored in STH solution for 5 hours rapidly established normal left ventricular functions (aortic flow, 111.5% +/- 2.5%; cardiac output, 99.1% +/- 1.2%; coronary flow, 85.0% +/- 3.4%; heart rate, 95.8% +/- 2.7%; and aortic pressure, 94.6%). A group of hearts arrested with STH solution but stored in saline solution recovered more slowly, had only partial return of function (aortic flow, 73.6% +/- 14.8%; p less than 0.01 vs STH/STH group), and had significantly greater tissue water content (8.020 +/- 0.080 vs 6.870 +/- 0.126 ml/gm dry wt; p less than 0.01). These results demonstrate the superior preservation of explanted hearts at 4 degrees C obtained by STH cardioplegic solution compared with UW solution under conditions used for transplantation.
关于威斯康星大学（UW）心脏停搏液在心脏保存技术中有益作用的报道存在矛盾。因此，我们研究了在成年大鼠心脏中，采用非氧合心脏停搏液（UW或圣托马斯医院2号溶液[STH]）单次输注（3分钟）并在4℃下浸泡于相同溶液或盐溶液中保存时心肌保护的效果。采用离体工作心脏标本（每组n = 8）评估心脏停搏前（20分钟常温灌注）和缺血后左心室功能。四组心脏在UW溶液中进行5、8、10和20小时的冷缺血（4℃）。保存8至20小时的心脏缺血后心脏泵功能无恢复（主动脉流量为0%），心肌高能磷酸盐水平降低，且高度水肿（增加50%至70%）。保存5小时后，主动脉流量、冠状动脉流量和主动脉压力的恢复也较差（分别为55.0%±19.4%、67.1%±5.1%和58.1%±11.7%），但三磷酸腺苷、磷酸肌酸和三磷酸鸟苷恢复良好（分别为18.54±1.42、29.99±2.05和1.64±0.14μmol/g干重）。相比之下，用STH溶液停搏并保存5小时的心脏迅速建立了正常的左心室功能（主动脉流量为111.5%±2.5%；心输出量为99.1%±1.2%；冠状动脉流量为85.0%±3.4%；心率为95.8%±2.7%；主动脉压力为94.6%）。一组用STH溶液停搏但保存在盐溶液中的心脏恢复较慢，仅部分功能恢复（主动脉流量为73.
