Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia

Vinod H. Thourani, Russell S. Ronson, David G.L. Van Wylen, Steven T. Shearer, Sara L. Katzmark, Zhi Qing Zhao, David C. Han, Robert A. Guyton, Jakob Vinten-Johansen

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background - Various studies have reported that the administration of adenosine (ADO) in cardioplegia reduces myocardial ischemic injury, but this timing may not utilize ADO's potential against myocardial reperfusion injury. This study tested the hypothesis that ADO-supplemented blood cardioplegia (BCP) or ADO administered during reperfusion reduces postischemic dysfunction after severe regional ischemia. Methods and Results - After 75 minutes of left anterior descending coronary artery occlusion, total cardiopulmonary bypass was initiated; cold (4°C) antegrade BCP (8:1 blood:crystalloid) was delivered every 20 minutes for the first 3 doses, and 27°C BCP was delivered for the terminal infusion. Dogs (n=6 per group) received unsupplemented BCP, ADO (100 μmol/L/L) supplemented in all infusions of BCP (ADO-CP), or ADO (100 μmol · L-1 · L-1) supplemented only in the terminal infusion of BCP followed by intravenous ADO (140 μg · kg-1 · min-1) infusion for the first 30 minutes of reperfusion (ADO-R). Postischemic regional systolic shortening was significantly greater in the ADO-R group (5±2.0%) than in the BCP group (-3±1.0%), but not in the ADO-CP group (2±0.2%). Postischemic regional diastolic stiffness in the area at risk during end reperfusion was lower with ADO-R (1.8±0.3%) than with ADO-CP (2.7±0.3%) or BCP (4.4±0.5%). Infarct size was reduced in the ADO-CP (29±2%) and ADO-R (21±2%) groups compared with the BCP group (42±4%). Edema in the myocardial area at risk was decreased in the ADO-CP (82±0.2%) and ADO-R (80±0.4%) groups compared with the BCP group (86±0.7%). Adherence of fluorescently labeled neutrophils (PMNs) to postischemic coronary artery endothelium was attenuated by ADO-R (55±2 PMNs/mm2), but not by ADO-CP (114±5 PMNs/mm2), compared with BCP (118±3 PMNs/mm2). Conclusions - The results show that BCP supplemented with ADO reduces infarct size, preserves postischemic systolic and diastolic regional function but does not attenuate coronary artery endothelial dysfunction unless administered during reperfusion.

Original languageEnglish (US)
Pages (from-to)II376-II383
JournalCirculation
Volume100
Issue number19 SUPPL.
StatePublished - Nov 9 1999

Fingerprint

Induced Heart Arrest
Adenosine
Ischemia
Reperfusion
Blood Group Antigens
Coronary Vessels
Myocardial Reperfusion Injury

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Thourani, V. H., Ronson, R. S., Van Wylen, D. G. L., Shearer, S. T., Katzmark, S. L., Zhao, Z. Q., ... Vinten-Johansen, J. (1999). Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia. Circulation, 100(19 SUPPL.), II376-II383.
Thourani, Vinod H. ; Ronson, Russell S. ; Van Wylen, David G.L. ; Shearer, Steven T. ; Katzmark, Sara L. ; Zhao, Zhi Qing ; Han, David C. ; Guyton, Robert A. ; Vinten-Johansen, Jakob. / Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia. In: Circulation. 1999 ; Vol. 100, No. 19 SUPPL. pp. II376-II383.
@article{998ea4c66ced4555a86d3e9df3bfbb82,
title = "Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia",
abstract = "Background - Various studies have reported that the administration of adenosine (ADO) in cardioplegia reduces myocardial ischemic injury, but this timing may not utilize ADO's potential against myocardial reperfusion injury. This study tested the hypothesis that ADO-supplemented blood cardioplegia (BCP) or ADO administered during reperfusion reduces postischemic dysfunction after severe regional ischemia. Methods and Results - After 75 minutes of left anterior descending coronary artery occlusion, total cardiopulmonary bypass was initiated; cold (4°C) antegrade BCP (8:1 blood:crystalloid) was delivered every 20 minutes for the first 3 doses, and 27°C BCP was delivered for the terminal infusion. Dogs (n=6 per group) received unsupplemented BCP, ADO (100 μmol/L/L) supplemented in all infusions of BCP (ADO-CP), or ADO (100 μmol · L-1 · L-1) supplemented only in the terminal infusion of BCP followed by intravenous ADO (140 μg · kg-1 · min-1) infusion for the first 30 minutes of reperfusion (ADO-R). Postischemic regional systolic shortening was significantly greater in the ADO-R group (5±2.0{\%}) than in the BCP group (-3±1.0{\%}), but not in the ADO-CP group (2±0.2{\%}). Postischemic regional diastolic stiffness in the area at risk during end reperfusion was lower with ADO-R (1.8±0.3{\%}) than with ADO-CP (2.7±0.3{\%}) or BCP (4.4±0.5{\%}). Infarct size was reduced in the ADO-CP (29±2{\%}) and ADO-R (21±2{\%}) groups compared with the BCP group (42±4{\%}). Edema in the myocardial area at risk was decreased in the ADO-CP (82±0.2{\%}) and ADO-R (80±0.4{\%}) groups compared with the BCP group (86±0.7{\%}). Adherence of fluorescently labeled neutrophils (PMNs) to postischemic coronary artery endothelium was attenuated by ADO-R (55±2 PMNs/mm2), but not by ADO-CP (114±5 PMNs/mm2), compared with BCP (118±3 PMNs/mm2). Conclusions - The results show that BCP supplemented with ADO reduces infarct size, preserves postischemic systolic and diastolic regional function but does not attenuate coronary artery endothelial dysfunction unless administered during reperfusion.",
author = "Thourani, {Vinod H.} and Ronson, {Russell S.} and {Van Wylen}, {David G.L.} and Shearer, {Steven T.} and Katzmark, {Sara L.} and Zhao, {Zhi Qing} and Han, {David C.} and Guyton, {Robert A.} and Jakob Vinten-Johansen",
year = "1999",
month = "11",
day = "9",
language = "English (US)",
volume = "100",
pages = "II376--II383",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "19 SUPPL.",

}

Thourani, VH, Ronson, RS, Van Wylen, DGL, Shearer, ST, Katzmark, SL, Zhao, ZQ, Han, DC, Guyton, RA & Vinten-Johansen, J 1999, 'Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia', Circulation, vol. 100, no. 19 SUPPL., pp. II376-II383.

Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia. / Thourani, Vinod H.; Ronson, Russell S.; Van Wylen, David G.L.; Shearer, Steven T.; Katzmark, Sara L.; Zhao, Zhi Qing; Han, David C.; Guyton, Robert A.; Vinten-Johansen, Jakob.

In: Circulation, Vol. 100, No. 19 SUPPL., 09.11.1999, p. II376-II383.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia

AU - Thourani, Vinod H.

AU - Ronson, Russell S.

AU - Van Wylen, David G.L.

AU - Shearer, Steven T.

AU - Katzmark, Sara L.

AU - Zhao, Zhi Qing

AU - Han, David C.

AU - Guyton, Robert A.

AU - Vinten-Johansen, Jakob

PY - 1999/11/9

Y1 - 1999/11/9

N2 - Background - Various studies have reported that the administration of adenosine (ADO) in cardioplegia reduces myocardial ischemic injury, but this timing may not utilize ADO's potential against myocardial reperfusion injury. This study tested the hypothesis that ADO-supplemented blood cardioplegia (BCP) or ADO administered during reperfusion reduces postischemic dysfunction after severe regional ischemia. Methods and Results - After 75 minutes of left anterior descending coronary artery occlusion, total cardiopulmonary bypass was initiated; cold (4°C) antegrade BCP (8:1 blood:crystalloid) was delivered every 20 minutes for the first 3 doses, and 27°C BCP was delivered for the terminal infusion. Dogs (n=6 per group) received unsupplemented BCP, ADO (100 μmol/L/L) supplemented in all infusions of BCP (ADO-CP), or ADO (100 μmol · L-1 · L-1) supplemented only in the terminal infusion of BCP followed by intravenous ADO (140 μg · kg-1 · min-1) infusion for the first 30 minutes of reperfusion (ADO-R). Postischemic regional systolic shortening was significantly greater in the ADO-R group (5±2.0%) than in the BCP group (-3±1.0%), but not in the ADO-CP group (2±0.2%). Postischemic regional diastolic stiffness in the area at risk during end reperfusion was lower with ADO-R (1.8±0.3%) than with ADO-CP (2.7±0.3%) or BCP (4.4±0.5%). Infarct size was reduced in the ADO-CP (29±2%) and ADO-R (21±2%) groups compared with the BCP group (42±4%). Edema in the myocardial area at risk was decreased in the ADO-CP (82±0.2%) and ADO-R (80±0.4%) groups compared with the BCP group (86±0.7%). Adherence of fluorescently labeled neutrophils (PMNs) to postischemic coronary artery endothelium was attenuated by ADO-R (55±2 PMNs/mm2), but not by ADO-CP (114±5 PMNs/mm2), compared with BCP (118±3 PMNs/mm2). Conclusions - The results show that BCP supplemented with ADO reduces infarct size, preserves postischemic systolic and diastolic regional function but does not attenuate coronary artery endothelial dysfunction unless administered during reperfusion.

AB - Background - Various studies have reported that the administration of adenosine (ADO) in cardioplegia reduces myocardial ischemic injury, but this timing may not utilize ADO's potential against myocardial reperfusion injury. This study tested the hypothesis that ADO-supplemented blood cardioplegia (BCP) or ADO administered during reperfusion reduces postischemic dysfunction after severe regional ischemia. Methods and Results - After 75 minutes of left anterior descending coronary artery occlusion, total cardiopulmonary bypass was initiated; cold (4°C) antegrade BCP (8:1 blood:crystalloid) was delivered every 20 minutes for the first 3 doses, and 27°C BCP was delivered for the terminal infusion. Dogs (n=6 per group) received unsupplemented BCP, ADO (100 μmol/L/L) supplemented in all infusions of BCP (ADO-CP), or ADO (100 μmol · L-1 · L-1) supplemented only in the terminal infusion of BCP followed by intravenous ADO (140 μg · kg-1 · min-1) infusion for the first 30 minutes of reperfusion (ADO-R). Postischemic regional systolic shortening was significantly greater in the ADO-R group (5±2.0%) than in the BCP group (-3±1.0%), but not in the ADO-CP group (2±0.2%). Postischemic regional diastolic stiffness in the area at risk during end reperfusion was lower with ADO-R (1.8±0.3%) than with ADO-CP (2.7±0.3%) or BCP (4.4±0.5%). Infarct size was reduced in the ADO-CP (29±2%) and ADO-R (21±2%) groups compared with the BCP group (42±4%). Edema in the myocardial area at risk was decreased in the ADO-CP (82±0.2%) and ADO-R (80±0.4%) groups compared with the BCP group (86±0.7%). Adherence of fluorescently labeled neutrophils (PMNs) to postischemic coronary artery endothelium was attenuated by ADO-R (55±2 PMNs/mm2), but not by ADO-CP (114±5 PMNs/mm2), compared with BCP (118±3 PMNs/mm2). Conclusions - The results show that BCP supplemented with ADO reduces infarct size, preserves postischemic systolic and diastolic regional function but does not attenuate coronary artery endothelial dysfunction unless administered during reperfusion.

UR - http://www.scopus.com/inward/record.url?scp=0344339189&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344339189&partnerID=8YFLogxK

M3 - Article

C2 - 10567333

AN - SCOPUS:0344339189

VL - 100

SP - II376-II383

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 19 SUPPL.

ER -

Thourani VH, Ronson RS, Van Wylen DGL, Shearer ST, Katzmark SL, Zhao ZQ et al. Adenosine-supplemented blood cardioplegia attenuates postischemic dysfunction after severe regional ischemia. Circulation. 1999 Nov 9;100(19 SUPPL.):II376-II383.