Myocardial Recovery, Metabolism, and Structure after Cardiac Arrest with Cardioplexol

Carina Hemmerich; Martina Heep; Ulrich Gärtner; Zulfugar Timur Taghiyev; Matthias Schneider; Andreas Böning

doi:10.1055/s-0043-1772210

Myocardial Recovery, Metabolism, and Structure after Cardiac Arrest with Cardioplexol

Thorac Cardiovasc Surg. 2023 Aug 10. doi: 10.1055/s-0043-1772210. Online ahead of print.

Authors

Carina Hemmerich¹, Martina Heep¹, Ulrich Gärtner², Zulfugar Timur Taghiyev¹, Matthias Schneider³, Andreas Böning^{1

4}

Affiliations

¹ Department of Cardiovascular Surgery, University Hospitals Giessen and Marburg Campus Giessen, Giessen, Germany.
² Institute of Anatomy and Cell Biology, German Center for Lung Research, Justus Liebig University Giessen, Giessen, Germany.
³ Medical and Forensic Veterinary Clinic, Department of Small Animal Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany.
⁴ Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Giessen, Germany.

PMID: 37562431
DOI: 10.1055/s-0043-1772210

Abstract

Objectives: Clinical studies indicate encouraging cardioprotective potential for Cardioplexol. Its cardioprotective capacities during 45 minutes of ischemia compared with pure no-flow ischemia or during 90 minutes of ischemia compared with Calafiore cardioplegia were investigated experimentally.

Methods: Forty-four rat hearts were isolated and inserted into a blood-perfused pressure-controlled Langendorff apparatus. In a first step, cardiac arrest was induced by Cardioplexol or pure no-flow ischemia lasting 45 minutes. In a second step, cardiac arrest was induced by Cardioplexol or Calafiore cardioplegia lasting 90 minutes. For both experimental steps, cardiac function, metabolic parameters, and troponin I levels were evaluated during 90 minutes of reperfusion. At the end of reperfusion, hearts were fixed, and ultrastructural integrity was examined by electron microscopy.

Results: Step 1: after 90 minutes of reperfusion, hearts exposed to Cardioplexol had significantly higher left ventricular developed pressure (CP-45': 74%BL vs. no-flow-45': 45%BL; p = 0.046) and significantly better maximal left ventricular relaxation (CP-45': 84%BL vs. no-flow-45': 51%BL; p = 0.012). Oxygen consumption, lactate production, and troponin levels were similar in both groups. Step 2: left ventricular developed pressure was lower (22 vs. 48% of BL; p = 0.001) and coronary flow was lower (24 vs. 53% of BL; p = 0.002) when Cardioplexol was used compared with Calafiore cardioplegia. Troponin I levels were significantly higher under Cardioplexol (358.9 vs. 106.1 ng/mL; p = 0.016).

Conclusion: Cardioplexol significantly improves functional recovery after 45 minutes of ischemia compared with pure ischemia. However, Cardioplexol protects the myocardium from ischemia/reperfusion-related damage after 90 minutes of ischemia worse than Calafiore cardioplegia.