Cardioprotection afforded by St Thomas solution is enhanced by emulsified isoflurane in an isolated heart ischemia reperfusion injury model in rats

J Cardiothorac Vasc Anesth. 2010 Feb;24(1):99-103. doi: 10.1053/j.jvca.2009.10.016.

Abstract

Objective: The purpose of this study was to investigate whether adding emulsified isoflurane to St Thomas cardioplegia solution could enhance the cardiac protection after cardioplegic arrest in rats.

Design: A randomized, blind study.

Setting: A university laboratory.

Participants: Thirty male Sprague-Dawley rats.

Interventions: Thirty isolated heart preparations were randomly divided into 3 groups (n = 10/group) according to the different cardioplegia solutions being given: St Thomas solution mixed with emulsified isoflurane (containing 2.8% of isoflurane, group EI), St Thomas solution mixed with emulsified Intralipid (Huarui Pharmacy, Wuxi, Jiangsu, China) (group EL), and St Thomas solution alone (group St). In the 35-minute normothermic ischemia period, infusion of cardioplegia solution was repeated every 15 minutes. After the 35-minute ischemia period, the heart was perfused with Krebs-Henseleit buffer for another 2 hours.

Measurements and main results: The functional parameters of the heart were monitored throughout the experiments. The coronary effluent was collected for measuring the activity of CK-MB 30 minutes after reperfusion, and the infarct size was assessed at the end of reperfusion. The infarct size in group EI (24% +/- 4%) was reduced when compared with that in group EL (31% +/- 8%, p < 0.05) and group St (43% +/- 9%, p < 0.001). The CK-MB activity in group EI was decreased significantly when compared with that in group EL and group St (p < 0.05). The functional recovery in group EI also was improved. Compared with standard St Thomas solution alone, adding 30% Intralipid alone also significantly reduced the infarct size and the CK-MB leakage and improved the recovery of the mechanical function.

Conclusions: St Thomas cardioplegia solution supplemented with emulsified isoflurane enhanced its cardioprotection in an isolated heart ischemia reperfusion injury model in rats.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthetics, Inhalation / pharmacology*
  • Animals
  • Bicarbonates / chemistry
  • Bicarbonates / pharmacology
  • Calcium Chloride / chemistry
  • Calcium Chloride / pharmacology
  • Cardioplegic Solutions / pharmacology*
  • Creatine Kinase, MB Form / analysis
  • Disease Models, Animal
  • Fat Emulsions, Intravenous / pharmacology
  • Heart / drug effects*
  • Hemodynamics / drug effects
  • Isoflurane / pharmacology*
  • Magnesium / chemistry
  • Magnesium / pharmacology
  • Male
  • Myocardial Infarction / pathology
  • Myocardial Infarction / prevention & control
  • Potassium Chloride / chemistry
  • Potassium Chloride / pharmacology
  • Random Allocation
  • Rats
  • Rats, Sprague-Dawley
  • Reperfusion Injury / drug therapy*
  • Sodium Chloride / chemistry
  • Sodium Chloride / pharmacology
  • Therapeutics

Substances

  • Anesthetics, Inhalation
  • Bicarbonates
  • Cardioplegic Solutions
  • Fat Emulsions, Intravenous
  • St. Thomas' Hospital cardioplegic solution
  • Sodium Chloride
  • Potassium Chloride
  • Isoflurane
  • Creatine Kinase, MB Form
  • Magnesium
  • Calcium Chloride