Zhulkov Maksim O, Sirota Dmitry A, Zykov Ilya S, Poveshchenko Olga V, Surovtseva Maria A, Kim Irina A, Protopopov Andrey V, Sabetov Azat K, Agaeva Khava A, Makaev Alexandr G, Nadeev Aleksandr P, Kliver Vladislav E, Kliver Evgeniy E, Volkov Alexander M, Karmadonova Natalya A, Smirnov Yaroslav M, Limanskiy Alexey D, Tarkova Aleksandra R, Chernyavskiy Aleksandr M
Adult Cardiac Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation.
Department of Cardiovascular Surgery, Novosibirsk State Medical University, Novosibirsk, Russian Federation.
Braz J Cardiovasc Surg. 2025 Feb 24;40(2):e20240080. doi: 10.21470/1678-9741-2024-0080.
To evaluate the effects of intracoronary iopromide (Ultravist®, Germany) administration on the recovery of cardiac pump function and cardiomyocytes metabolism during ex vivo cold preservation of pig hearts in the early posttransplant period.
Three-month-old mini pigs weighing 73 ± 2.8 kg were used as experimental models (n=12). Physiological parameters were obtained with the IntelliVue MP70 system (Philips, Netherlands). Blood samples were taken from the coronary sinus to evaluate myocardial ischemia markers - troponin I, creatine phosphokinase-MB, lactate dehydrogenase, and lactate - and apex biopsy was performed before and after the ischemia period according to the protocol. Myocardial samples were taken from the left ventricle and prepared according to the protocol either.
Twelve orthotopic heart transplantations were performed during the study. Sample size was divided into two groups with six each. Cardiac output was 5.11 (4.99; 5.41) l/min and 5.77 (4.97; 6.62) l/min (P-0.0009) after 120 minutes of cardiac activity in both groups. Change of lactate dehydrogenase, creatine phosphokinase-MB, and troponin I levels in the coronary sinus blood were significantly higher in the early reperfusion period. However, there were no statistically significant differences between the groups (P>0.05). Myocardial oxygen consumption was considerably reduced during reperfusion but returned to baseline by 60 minutes of postischemia without significant differences between groups (P>0.05).
We observed that intracoronary iopromide administration was safe during the ex vivo stage cold preservation phase of the study. Intracoronary iopromide administration did not affect cardiac pump function and cardiomyocytes metabolism in the early posttransplant period.
评估冠状动脉内注射碘普罗胺(德国产优维显®)对猪心脏在移植后早期离体低温保存期间心脏泵功能恢复及心肌细胞代谢的影响。
选用体重73±2.8 kg的3月龄小型猪作为实验模型(n = 12)。使用IntelliVue MP70系统(荷兰飞利浦公司)获取生理参数。从冠状窦采集血样以评估心肌缺血标志物——肌钙蛋白I、肌酸磷酸激酶同工酶MB、乳酸脱氢酶和乳酸,并根据方案在缺血期前后进行心尖活检。也从左心室采集心肌样本并按方案制备。
研究期间共进行了12例原位心脏移植。样本量分为两组,每组6例。两组心脏活动120分钟后心输出量分别为5.11(4.99;5.41)升/分钟和5.77(4.97;6.62)升/分钟(P = 0.0009)。在再灌注早期冠状窦血中乳酸脱氢酶、肌酸磷酸激酶同工酶MB和肌钙蛋白I水平的变化显著更高。然而,两组之间无统计学显著差异(P>0.05)。再灌注期间心肌耗氧量显著降低,但在缺血后60分钟恢复至基线水平,两组之间无显著差异(P>0.05)。
我们观察到在研究的离体阶段低温保存期冠状动脉内注射碘普罗胺是安全的。冠状动脉内注射碘普罗胺在移植后早期不影响心脏泵功能和心肌细胞代谢。