Wang Jian, Xiang Bo, Deng Jixian, Lin Hung-Yu, Freed Darren H, Arora Rakesh C, Tian Ganghong
Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China.
National Research Council of Canada, 435 Ellice Avenue, Winnipeg, MB, Canada R3B 1Y6.
Biomed Res Int. 2017;2017:4107587. doi: 10.1155/2017/4107587. Epub 2017 Mar 20.
. Normothermic hyperkalemic cardioplegia arrest (NHCA) may not effectively preserve hypertrophied myocardium during open-heart surgery. Normothermic normokalemic beating perfusion (NNBP), keeping hearts empty-beating, was utilized as an alternative to evaluate its cardioprotective role. . Twelve hypertrophied pig hearts at 58.6 ± 7.2 days after ascending aorta banding underwent NNBP and NHCA, respectively. Near infrared myocardial perfusion imaging with indocyanine green (ICG) was conducted to assess myocardial perfusion. Left ventricular (LV) contractile function was assessed by cine MRI. TUNEL staining and western blotting for caspase-3 cleavage and cardiac troponin I (cTnI) degradation were conducted in LV tissue samples. . Ascending aortic diameter was reduced by 52.7% ± 0.4% at approximately fifty-eight days after banding. LV wall thickness was significantly higher in aorta banding than in sham operation. Myocardial blood flow reflected by maximum ICG absorbance value was markedly higher in NNBP than in NHCA. The amount of apoptotic cardiomyocyte was significantly lower in NNBP than in NHCA. NNBP alleviated caspase-3 cleavage and cTnI degradation associated with NHCA. NNBP displayed a substantially increased postoperative ejection fraction relative to NHCA. . NNBP was better than NHCA in enhancing myocardial perfusion, inhibiting cardiomyocyte apoptosis, and preserving LV contractile function for hypertrophied hearts.
常温高钾停搏液停搏（NHCA）在心脏直视手术期间可能无法有效保护肥厚心肌。常温正常血钾搏动灌注（NNBP），使心脏保持空搏状态，被用作一种替代方法来评估其心脏保护作用。12只在升主动脉缩窄后58.6±7.2天的肥厚猪心脏分别接受了NNBP和NHCA。采用吲哚菁绿（ICG）近红外心肌灌注成像评估心肌灌注。通过电影磁共振成像评估左心室（LV）收缩功能。对LV组织样本进行TUNEL染色以及针对半胱天冬酶-3裂解和心肌肌钙蛋白I（cTnI）降解的蛋白质印迹分析。缩窄后约58天时升主动脉直径减小了52.7%±0.4%。主动脉缩窄组的LV壁厚度显著高于假手术组。NNBP组中由ICG最大吸光度值反映的心肌血流量明显高于NHCA组。NNBP组中凋亡心肌细胞的数量明显低于NHCA组。NNBP减轻了与NHCA相关的半胱天冬酶-3裂解和cTnI降解。相对于NHCA，NNBP术后射血分数显著增加。对于肥厚心脏，NNBP在增强心肌灌注、抑制心肌细胞凋亡和保留LV收缩功能方面优于NHCA。
