Em. Hoenicke et Rj. Damiano, Superior 12-hour heart preservation with pinacidil hyperpolarizing solution compared to University of Wisconsin solution, J HEART LUN, 20(10), 2001, pp. 1106-1114
Background: A novel donor heart preservation solution was formulated to pro
duce hyperpolarized arrest with the potassium channel opener, pinacidil. Th
e superior cardioprotective efficacy of this solution has been demonstrated
previously when compared to University of Wisconsin solution following 4 h
ours of hypothermic ischemia. This study tested the hypothesis that pinacid
il solution may extend preservation time and provide superior cardioprotect
ive efficacy following 12 hours of ischemia.
Methods: Sixteen rabbit hearts were assigned to receive either pinacidil so
lution or University of Wisconsin solution in a crystalloid-perfused Langen
dorff model. Thirty minutes of initial perfusion preceded baseline data acq
uisition. Left ventricle pressure-volume curves were generated by inflating
an intra-ventricular latex balloon. Following cardioplegic administration,
hearts underwent 12 hours of hypothermic storage. After 60 minutes of repe
rfusion, post-ischemic data were acquired.
Results: Pinacidil solution demonstrated significantly better myocardial pr
eservation compared to University of Wisconsin solution, with better recove
ry of developed pressure (53.0 +/- 11.1% vs 20.7 +/- 4.3%, p = 0.017, respe
ctively), post-ischemic coronary flow (55.3 +/- 12.6% vs 23.9 +/- 4.3%, p =
0.034), maximum systolic dP/dT (46.4 +/- 8.3% vs 20.2 +/- 5.1%, p = 0.018)
and minimum diastolic -dP/dT (65.3 +/- 10.8% vs 20.2 +/- 5.1%, p = 0.002).
Diastolic compliance, expressed as baseline/post-ischemic diastolic slope
ratios, was also better preserved by pinacidil solution (0.55 +/- 0.09) vs
University of Wisconsin solution (0.40 +/- 0.03) (p = 0.135).
Conclusions: A novel pinacidil solution resulted in improved donor heart pr
eservation during 12 hours of hypothermic ischemia compared to the "gold st
andard," University of Wisconsin solution. Adopting alternative strategies
of hyperpolarized arrest may allow extension of preservation time beyond th
e limits of traditional depolarizing solutions.