Superior 12-hour heart preservation with pinacidil hyperpolarizing solution compared to University of Wisconsin solution

Citation
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
Citations number
32
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF HEART AND LUNG TRANSPLANTATION
ISSN journal
10532498 → ACNP
Volume
20
Issue
10
Year of publication
2001
Pages
1106 - 1114
Database
ISI
SICI code
1053-2498(200110)20:10<1106:S1HPWP>2.0.ZU;2-9
Abstract
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.