Centro de Ciências da Saúde de Vitória-EMESCAM, Vitória, ES, Brazil.
Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
Braz J Cardiovasc Surg. 2021 Apr 1;36(2):201-211. doi: 10.21470/1678-9741-2020-0320.
Heart preservation benefits cardiac performance after operations decreasing morbidity but the contribution of the vascular reactivity has been neglected.
We evaluated whether cardioprotective solutions, Krebs-Henseleit (KH), Bretschneider-HTK (BHTK), St. Thomas No. 1 (STH-1), and Celsior (CEL), affect vascular reactivity. Methods: Aortic rings from Wistar rats were used in two protocols. First, the rings were exposed to BHTK, STH-1 or CEL for 1 hour of hypoxia at 37 °C. Second, the rings were exposed to 10 °C or 20 °C for 1 hour under hypoxia. After treatment, the rings were immersed in KH at 37 °C, endothelial integrity was tested and concentration- response curves to phenylephrine were performed.
In the first protocol, the solutions did not damage the endothelium; CEL and BHTK reduced KCl-induced contractions but not STH- 1; only CEL and BHTK reduced vascular reactivity; there was a positive correlation between Rmax and KCl concentration. At 20 °C, 1 hour under hypoxia, the solutions produced similar KCl-induced contractions without endothelial damage. CEL, BHTK and STH-1 decreased vascular reactivity. At 10 °C, STH-1 increased reactivity but CEL and BHTK decreased. After 1 hour under hypoxia in CEL or BHTK solutions, reactivity was similar at different temperatures. At 20 °C, endothelial damage after exposure to STH-1 produced more vasoconstriction than CEL and BHTK. However, at 10 °C, endothelial damage after CEL and BHTK exposure elicited more vasoconstriction while STH-1 showed a small vasoconstrictor response, suggesting endothelial damage.
STH-1 decreased reactivity at 20 °C and increased at 10 °C. CEL promoted greater endothelial modulation at 10 °C than at 20 °C, while STH-1 promoted higher modulation at 20 °C than at 10 °C. Vascular tone was reduced by CEL and BHTK exposure, also depending on the KCl concentration.
心脏保存有利于术后心脏功能,降低发病率,但血管反应性的作用一直被忽视。
我们评估了心脏保护液(Krebs-Henseleit [KH]、Bretschneider-HTK [BHTK]、St. Thomas No. 1 [STH-1] 和 Celsior [CEL])是否影响血管反应性。方法:使用来自 Wistar 大鼠的主动脉环进行两个方案。首先,将环在 37°C 下暴露于 BHTK、STH-1 或 CEL 中 1 小时缺氧。其次,将环在 10°C 或 20°C 下缺氧 1 小时。治疗后,将环浸泡在 37°C 的 KH 中,测试内皮完整性,并进行苯肾上腺素浓度-反应曲线。
在第一个方案中,溶液没有损伤内皮;CEL 和 BHTK 减少了 KCl 引起的收缩,但 STH-1 没有;只有 CEL 和 BHTK 减少了血管反应性;Rmax 与 KCl 浓度呈正相关。在 20°C 下,1 小时缺氧下,溶液产生相似的 KCl 诱导收缩而没有内皮损伤。CEL、BHTK 和 STH-1 降低了血管反应性。在 10°C 下,STH-1 增加了反应性,但 CEL 和 BHTK 降低了反应性。在 CEL 或 BHTK 溶液中缺氧 1 小时后,在不同温度下的反应性相似。在 20°C 下,暴露于 STH-1 后内皮损伤产生的血管收缩比 CEL 和 BHTK 更多。然而,在 10°C 下,暴露于 CEL 和 BHTK 后内皮损伤引起的血管收缩更多,而 STH-1 显示出较小的血管收缩反应,提示内皮损伤。
STH-1 在 20°C 时降低反应性,在 10°C 时增加反应性。CEL 在 10°C 时比在 20°C 时引起更大的内皮调节作用,而 STH-1 在 20°C 时比在 10°C 时引起更高的调节作用。CEL 和 BHTK 的暴露降低了血管张力,也取决于 KCl 浓度。