Objective-The hypothesis is that partial nuclear factor-kappaB (NF-κB) inhibition can alleviate cardiopulmonary dysfunction associated with ischemia and reperfusion injury following CPB/ DHCA in a pediatric model.
Design-Animal case study.
Subjects-Two week-old piglets (5-7 kg).Interventions-Piglets received 100 mcg•kg −1 of SN50, a peptide inhibitor of NF-κB translocation and activation, 1 hr before CPB. The control group received saline. Animals were cooled to 18oC with CPB, the piglets were in DHCA for 120 min, and were then rewarmed on CPB to 38°C and maintained for 120 min after CPB/DHCA.Measurements-Sonomicrometry and pressure catheters collected hemodynamic data. Transmural left and right ventricular tissues were obtained at the terminal time point for determination of NF-κB activity by ELISA. Data are expressed as mean ± SD.Main Points-Oxygen delivery was maintained at 76±13 mL•min −1 at baseline and 75±5 mL•min −1 at 120 min after CPB/DHCA (P=.75) in SN50-treated animals vs. 99±26 mL•min −1 at baseline and 63±20 mL•min −1 at 120 min in the untreated group (P=.0001). Pulmonary vascular resistance (dynes•s −1 •cm −5 ) increased from 124±59 at baseline to 369±104 at 120 min in the untreated piglets (P=.001) compared with SN50-treated animals (100±24 at baseline and 169±88 at 120 minutes, P=.1). NF-κB activity was reduced 74% in left ventricles of SN50-treated compared with untreated animals (P<.001). Plasma endothelin-1 (pg•mL −1 ), an important vasoconstrictor regulated by NF-κB, increased from 2.1±0.4 to 14.2±5.7 in untreated animals (P=.004) but was elevated to only 4.5±2 with SN50 treatment (P=.005).Conclusions-Improvement of cardiopulmonary function after ischemia/reperfusion was associated with the reduction of NF-κB activity in piglet hearts. Maintenance of systemic oxygen delivery and alleviation of pulmonary hypertension after CPB/DHCA in piglets administered SN50, Address reprint requests to: Jodie Y. Duffy, PhD, Division of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., ML2004, Cincinnati, OH 45229, Phone: 513-636-8147, Fax: 513-636-6309, jodie.duffy@cchmc possibly through a reduction of circulating endothelin-1, suggest that selective inhibition of NF-κB activity may reduce ischemia and reperfusion injury after pediatric cardiac surgery.