Zhu Q, Yang X, Hicks G L, Wang T
Department of Surgery, University of Rochester, NY 14642, USA.
J Surg Res. 1996 Feb 15;61(1):159-64. doi: 10.1006/jsre.1996.0098.
This study investigated the effect of intermittent perfusion (IP) pressures on functional preservation of the cold-stored isolated rat heart. The heart was flushed with cardioplegic solution #11 with ethylene diamine-tetraacetic acid and 2, 3-butanedione monoxime (CP-11EB), and stored at 0 degree C for 24 hr. During storage, the heart was intermittently perfused for 3 min at 10 and 17 hr of storage with 25 degrees C oxygenated CP-11EB. The IP pressures studied were: 20, 30, 40, 50, 60, 70, 80, and 100 mm Hg. Poststorage recovery of function was assessed with 30 min of working reperfusion. Control function of the unstored heart was: aortic flow (AF), 51.3 +/- 2.2 ml/min; coronary flow (CF), 25.8 +/- 1.2 ml/min; cardiac output (CO), 77.7 +/- 2.3 ml/min; work, 92.0 +/- 4.9 g-m/min; and coronary vascular resistance (CVR), 2.64 +/- .21 mm Hg-min/ml. Functional return in the 30,40,50,60,70, and 80 mm Hg groups was similar. Recovery in a representative group (60 mm Hg) was: AF, 52 +/- 3%; CF, 41 +/- 2%; CO, 48 +/- 3%; work, 42 +/- 3%; and CVR, 225 +/- 10% of the control. The total IP volume in this group was 71.0 +/- 1.7 ml; total lactate dehydrogenase (LDH) release during IP was 8.62 +/- .37 units/g dry; and end-storage tissue lactate was 52.6 +/- 6.4 mumole/g dry. As IP pressure decreased to 20 mm Hg, cardiac functional recovery declined significantly to AF, 35 +/- 6%; CF, 33 +/- 2%; CO, 34 +/- 5%; and work, 27 = 4% of control (P < .05 vs. 60 mm Hg group). The total IP volume decreased to 10.1 +/- .9 ml, tissue lactate content rose to 87.1 +/- 10.9 (P < .05 vs. 60 mm Hg group), but LDH release fell to 5.59 +/- .46 (P < .05 vs. 60 and 100 mm Hg groups). When IP pressure increased to 100 mm Hg, cardiac function was depressed with AF recovered to 25 +/- 3%; CF, 30 +/- 3%; CO, 26 +/- 3%; work, 21 +/- 3%; and CVR, 294 +/- 26% of control (P < .05 vs. 60 mm Hg group). IP volume increased to 100.7 +/- 2.4 ml; total LDH release increased to 19.1 +/- 1.2 (P < .05 vs. 60 mm Hg group), although tissue lactate (58.9 +/- 3.9) was not different from the 60 mm Hg group. End-storage tissue wet/dry weight ratio and myocardial adenosine triphosphate content were not different among the 20, 60, and 100 mm Hg groups. In conclusion, IP has a broad pressure optimum ranging from 30 to 80 mm Hg for 24-hr hypothermic preservation of the rat cardiac explant.
本研究调查了间歇性灌注（IP）压力对低温保存的离体大鼠心脏功能保存的影响。用含乙二胺四乙酸和2,3-丁二酮一肟的心脏停搏液#11（CP-11EB）冲洗心脏，并在0℃保存24小时。在保存期间，心脏在保存10小时和17小时时用25℃的氧合CP-11EB间歇性灌注3分钟。研究的IP压力为：20、30、40、50、60、70、80和100毫米汞柱。通过30分钟的工作再灌注评估保存后功能的恢复情况。未保存心脏的对照功能为：主动脉流量（AF），51.3±2.2毫升/分钟；冠状动脉流量（CF），25.8±1.2毫升/分钟；心输出量（CO），77.7±2.3毫升/分钟；功，92.0±4.9克-米/分钟；以及冠状动脉血管阻力（CVR），2.64±0.21毫米汞柱-分钟/毫升。30、40、50、60、70和80毫米汞柱组的功能恢复情况相似。一个代表性组（60毫米汞柱）的恢复情况为：AF为对照的52±3%；CF为对照的41±2%；CO为对照的48±3%；功为对照的42±3%；CVR为对照的225±10%。该组的总IP体积为71.0±1.7毫升；IP期间总乳酸脱氢酶（LDH）释放量为8.62±0.37单位/克干重；保存结束时组织乳酸含量为52.6±6.4微摩尔/克干重。当IP压力降至20毫米汞柱时，心脏功能恢复显著下降至AF为对照的35±6%；CF为对照的33±2%；CO为对照的34±5%；功为对照的27±4%（与60毫米汞柱组相比，P<0.05）。总IP体积降至10.1±0.9毫升，组织乳酸含量升至87.1±10.9（与60毫米汞柱组相比，P<0.05），但LDH释放量降至5.59±0.46（与60和100毫米汞柱组相比，P<0.05）。当IP压力升至100毫米汞柱时，心脏功能受到抑制，AF恢复至对照的25±3%；CF为对照的30±3%；CO为对照的26±3%；功为对照的21±3%；CVR为对照的294±26%（与60毫米汞柱组相比，P<0.05）。IP体积增加至100.7±2.4毫升；总LDH释放量增加至19.1±1.2（与60毫米汞柱组相比，P<0.05），尽管组织乳酸（58.9±3.9）与60毫米汞柱组无差异。20、60和100毫米汞柱组之间保存结束时组织湿/干重比和心肌三磷酸腺苷含量无差异。总之，对于大鼠心脏外植体的24小时低温保存，IP具有30至80毫米汞柱的较宽压力适宜范围。
