Myocardial protection against global ischemia with Krebs-Henseleit buffer-based cardioplegic solution.

Abstract

BACKGROUND:

The Krebs-Henseleit buffer is the best perfusion solution for isolated mammalian hearts. We hypothesized that a Krebs-Henseleit buffer-based cardioplegic solution might provide better myocardial protection than well-known crystalloid cardioplegic solutions because of its optimal electrolyte and glucose levels, presence of buffer systems, and mild hyperosmolarity.

METHODS:

Isolated Langendorff-perfused rat hearts were subjected to either global ischemia without cardioplegia (controls) or cardioplegic arrest for either 60 or 180 min, followed by 120 min of reperfusion. The modified Krebs-Henseleit buffer-based cardioplegic solution (mKHB) and St. Thomas' Hospital solution No. 2 (STH2) were studied. During global ischemia, the temperatures of the heart and the cardioplegic solutions were maintained at either 37°C (60 min of ischemia) or 22°C (moderate hypothermia, 180 min of ischemia). Hemodynamic parameters were registered throughout the experiments. The infarct size was determined through histochemical examination.

RESULTS:

Cardioplegia with the mKHB solution at moderate hypothermia resulted in a minimal infarct size (5 ± 3%) compared to that in the controls and STH2 solution (35 ± 7% and 19 ± 9%, respectively; P < 0.001, for both groups vs. the mKHB group). In contrast to the control and STH2-treated hearts, no ischemic contracture was registered in the mKHB group during the 180-min global ischemia. At normothermia, the infarct sizes were 4 ± 3%, 72 ± 6%, and 70 ± 12% in the mKHB, controls, and STH2 groups, respectively (P < 0.0001). In addition, cardioplegia with mKHB at normothermia prevented ischemic contracture and improved the postischemic functional recovery of the left ventricle (P < 0.001, vs. STH2).

CONCLUSIONS:

The data suggest that the Krebs-Henseleit buffer-based cardioplegic might be superior to the standard crystalloid solution (STH2).

• Authors: Sarkis M Minasian, Michael M Galagudza, Yuri V Dmitriev, Dmitry I Kurapeev, Timur D Vlasov
• Journal: Journal of cardiothoracic surgery (J Cardiothorac Surg) Vol. 8 Pg. 60 (Apr 02 2013) ISSN: 1749-8090 [Electronic] England
• PMID: 23547937 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cardioplegic Solutions
• Cardiotonic Agents
• Krebs-Henseleit solution
• Tromethamine
• Glucose

Topics

• Animals
• Cardioplegic Solutions (chemistry, pharmacology)
• Cardiotonic Agents (chemistry, pharmacology)
• Glucose (chemistry, pharmacology)
• Heart Arrest
• Heart Rate (drug effects)
• Male
• Myocardial Infarction (pathology)
• Myocardial Reperfusion Injury (pathology, prevention & control)
• Rats
• Rats, Wistar
• Statistics, Nonparametric
• Tromethamine (chemistry, pharmacology)
• Ventricular Fibrillation
• Ventricular Pressure (drug effects)