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Antiapoptotic intervention in repeated blood cardioplegia: a porcine study of myocardial function.
MedLine Citation:
PMID:  21352998     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Lethal reperfusion injury has been associated with apoptotic cell death. Insulin and insulin-like growth factors (IGF-I/IGF-II) may modulate this cell death when administered at the onset of reperfusion after ischemia. We explored if antiapoptotic treatment with IGF-II could influence left ventricular function in an experimental model with cardiopulmonary bypass and repeated oxygenated blood cardioplegia.
METHODS: Twenty pigs underwent cardiopulmonary bypass with aortic cross-clamping for 60 minutes. In controls, hearts were arrested with cold, oxygenated blood cardioplegia repeated after 20 and 40 minutes. In the intervention group IGF-II was added to the cardioplegic solution at 20 and 40 minutes. After declamping and weaning from cardiopulmonary bypass, left ventricular global and local function was evaluated with a conductance catheter and tissue velocity imaging. Three hours after declamping the anterior left ventricle wall was divided in three layers and studied for blood flow rate with microspheres, Akt phosphorylation, and caspase-3 cleavage. Troponin-T levels were measured at baseline and after 3 hours of reperfusion.
RESULTS: A reduction of myocardial levels of cleaved caspase-3 (p < 0.001) was found in the subendocardial wall layer and serum troponin-T was reduced (p < 0.025) in the IGF-II group 3 hours after declamping. In the IGF-II treated animals, left ventricular preload recruitable stroke work was low 1 hour after declamping and increased to levels higher than in controls (p < 0.025) 3 hours after declamping. Other cardiac variables did not differ between groups.
CONCLUSIONS: When added to repeated cold blood cardioplegia, IGF-II reduces apoptosis and ischemia-reperfusion injury with minor effects on cardiac function.
Authors:
Pirjo-Riitta Salminen; Anne Kristin Jonassen; Eva-Katrine Aarnes; Chistian Arvei Moen; Lodve Stangeland; Finn Eliassen; Ruth Kongsvik; Knut Matre; Rune Haaverstad; Ketil Grong
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  91     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  784-91     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Surgical Sciences, University of Bergen, Bergen, Norway.
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