Left ventricular dysfunction after two hours of polarizing or depolarizing cardioplegic arrest in a porcine model

Aass, Terje; Stangeland, Lodve; Moen, Christian Arvei; Solholm, Atle; Dahle, Geir; Chambers, David; Urban, Malte; Nesheim, Knut; Haaverstad, Rune; Matre, Knut; Grong, Ketil

doi:10.1177/0267659118791357

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…Исходя из результатов работы, перфузию сердца при искусственно вызванной ФЖ можно предложить использовать при длительных кардиохирургических операциях, что может повысить устойчивость сердца к ишемии и предотвратить реперфузионные осложнения, что благоприятно повлияет на течение операции и послеоперационное восстановление сердца. Для «поддержания» оперируемого сердца используют кардиоплегию, но при кардиоплегии сердце страдает от ишемии и реперфузии [22,23], причем защите миокарда от ишемии и реперфузии при кардиоплегии посвящен ряд работ [24,25].…”

Section: Discussionunclassified

Destabilization of the Organized Structure of Ventricular Fibrillation During Reperfusion

Gurianov,

Yablonsky

2023

Obŝaâ reanimatologiâ

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Aim: to study the effect of reperfusion on the organized frequency-amplitude structure of ventricular fibrillation (VF) in the dog heart.Materials and methods. We conducted 4 experiments on 8 dogs. In each experiment, the isolated heart of one dog was perfused with the blood of the second (supporting) dog. In 4 experiments on an isolated artificially perfused heart, 6 episodes of 3-minute ischemia and 10-minute reperfusion of the heart were performed in VF (1-2 episodes of ischemia-reperfusion in one experiment). Each episode of 3-minute ischemia in VF was preceded by a 10-minute perfusion of the heart in VF. Ventricular electrogram was recorded during VF episodes. A frequency-amplitude (spectral) analysis of one-second segments of the electrogram was performed, and the proportion (in %) of 0.5-15 Hz frequency oscillations in 10-second segments of the electrogram was determined in 6 episodes of perfusion, ischemia and reperfusion in VF (M±m, n=60). The VF frequency-amplitude structures during ischemia and reperfusion were compared with the stable VF frequency-amplitude structure during perfusion taken as the control. The nonparametric Welch criterion in the “The R Project for Statistical Computing” software environment was used to compare the VF parameters during perfusion, ischemia and reperfusion.Results. 9-10 Hz frequency oscillations dominated in the VF frequency-amplitude structure during heart perfusion, taken as the control. In the first 30 seconds of ischemia, the frequency and amplitude of the dominant oscillations did not significantly change vs VF control obtained during cardiac perfusion. A decrease of dominant oscillations frequency up to 6.5-7.5 Hz, and of the proportion of oscillations - up to 26% was documented at the 3rd minute of ischemia. At the 1st minute of reperfusion, the frequency of dominant oscillations increased to 13.5-14.5 Hz, but the proportion of oscillations remained reduced to 26%, as at the 3rd minute of ischemia. At the 2nd minute of reperfusion, the frequency of dominant oscillations decreased to 9.5-10.5 Hz, and the proportion of dominant oscillations increased to 33%. The frequency and amplitude of the dominant oscillations stabilized at 3-10 minutes of reperfusion: oscillations at 9-10 Hz frequency accounted for 32-33% of the spectral power.Conclusion. Reperfusion in VF is characterized by transient destabilization of VF organized structure at the 1st minute of the procedure. VF organized structure regains stabilization within 2-10 minutes of reperfusion. Cardiac perfusion in intentionally induced VF can be used instead of cardioplegia during major cardiac surgery to boost cardiac resistance to ischemia and prevent or reduce reperfusion complications.

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Section: Discussionunclassified

Destabilization of the Organized Structure of Ventricular Fibrillation During Reperfusion

Gurianov,

Yablonsky

2023

Obŝaâ reanimatologiâ

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“…Therefore, direct comparisons of different cardioplegic solutions were performed. Comparisons between St. Thomas I and II cardioplegic solutions have shown enhanced functional recovery, better contractile efficiency, and improved energy status with St. Thomas I cardioplegia [ 21 , 22 , 23 , 24 ]. The novel HTK-N solution stabilizes hemoglobin and blood calcium levels, which can potentially increase kidney function [ 25 ].…”

Section: Investigations In Adult Pig Modelsmentioning

confidence: 99%

Relevance and Recommendations for the Application of Cardioplegic Solutions in Cardiopulmonary Bypass Surgery in Pigs

et al. 2021

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Cardioplegic solutions play a major role in cardiac surgery due to the fact that they create a silent operating field and protect the myocardium against ischemia and reperfusion injury. For studies on cardioplegic solutions, it is important to compare their effects and to have a valid platform for preclinical testing of new cardioplegic solutions and their additives. Due to the strong anatomical and physiological cardiovascular similarities between pigs and humans, porcine models are suitable for investigating the effects of cardioplegic solutions. This review provides an overview of the results of the application of cardioplegic solutions in adult or pediatric pig models over the past 25 years. The advantages, disadvantages, limitations, and refinement strategies of these models are discussed.

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“…The so-called Millar catheter is available in different versions and is being used for different applications. For experimental research different sizes allow its use in various animal species, from mice (3) to larger animals (4). Various types support measurement of physiological pressures, such as airway or cardiovascular pressures, such as left ventricular pressure (5, 6) or even electrophysiological applications.…”

Section: Introductionmentioning

confidence: 99%

Transthoracic Echocardiography of the Neonatal Laboratory Piglet

et al. 2019

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Background: Newborn piglets are commonly used in biomedical research. However, cardiovascular imaging of this species is quite challenging. For point of care diagnostics of heart function transthoracic echocardiography may be used, which appears to differ comparing newborn piglets with adult pigs. To date, there are few data or studies on the feasibility and quality of measurement of functional echocardiographic parameters in very small neonatal piglets. Objectives: To study the feasibility of transthoracic echocardiography in very small newborn piglets in supine position. Methods: In 44 anesthetized and intubated newborn piglets, positioned in supine position [age 32 h (12–44 h), weight 1,220 g (1,060–1,495 g), median (IQR)] transthoracic echocardiography was performed using a point of care ultrasound device (M-Turbo © , FujiFilm SonoSite BV, Amsterdam, Netherlands), and a standard ultrasound transducer. Results: Using 2D- and M-mode-imaging left- and right-sided heart structures were accessible to transthoracic echocardiography in neonatal piglets. Diameters of the interventricular septum, the left ventricle, and the posterior wall were measured and ejection fraction and shortening fraction was calculated. Both left and right ventricular outflow tract could be imaged, and ventricular filling and systolic function could be evaluated. Furthermore, we were able to assess shunts of fetal circulation, such as patent ductus arteriosus, structure of the heart valves and congenital heart defects including ventricular septal defect. Conclusions: In summary, transthoracic echocardiography is feasible for assessment of cardiovascular function even in very small newborn laboratory piglets in supine position.

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Left ventricular dysfunction after two hours of polarizing or depolarizing cardioplegic arrest in a porcine model

Abstract: Myocardial protection for two hours of polarizing cardioplegic arrest with STH-POL in oxygenated blood is non-inferior compared to STH-2 blood cardioplegia. STH-POL cardioplegia alleviates the mismatch between myocardial function and perfusion after weaning from CPB.

Cited by 6 publications

References 36 publications

Destabilization of the Organized Structure of Ventricular Fibrillation During Reperfusion

Destabilization of the Organized Structure of Ventricular Fibrillation During Reperfusion

Relevance and Recommendations for the Application of Cardioplegic Solutions in Cardiopulmonary Bypass Surgery in Pigs

Transthoracic Echocardiography of the Neonatal Laboratory Piglet

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