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-45ˊ: 74%BL vs. no-flow-45ˊ: 45%BL;
p = 0.046) and significantly better maximal left ventricular relaxation (CP-45ˊ: 84%BL
vs. no-flow-45ˊ: 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.
Keywords
myocardial protection - crystalloid cardioplegia - ischemia and reperfusion - myocardial
preservation - Cardioplexol - Calafiore
