Cardiomyocyte Apoptosis after Cardioplegic Ischemia: Comparison to Unprotected Regional Ischemia-Reperfusion

: Malmberg M, Parkka J, Vahasilta T, Saraste A, Laitio T, Kiss J, Latva-Hirvela J, Saukko P, Savunen T

Publisher: KARGER

: 2011

: European Surgical Research

: EUROPEAN SURGICAL RESEARCH

: EUR SURG RES

: 1

: 46

: 1

: 19

: 25

: 7

: 0014-312X

DOI: https://doi.org/10.1159/000321875

Background: Cardiomyocyte apoptosis might contribute to left ventricular (LV) dysfunction following cardiac surgery. Magnetic resonance imaging is considered the most accurate method of determining LV function. We compared apoptosis (by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, TUNEL, staining and detection of caspase 3 activation) and LV function after regional ischemia-reperfusion (I-R) and global cardioplegic ischemia. Methods: Pigs were randomized to undergo regional myocardial I-R for 20 + 20 min, global myocardial ischemia with cardiopulmonary bypass (CPB) for 40 min or CPB without ischemia (control), followed by 274 min of reperfusion. Results: Compared with the control group, the number of TUNEL-positive cardiomyocytes was higher in the global ischemia group with CPB (0.024 +/- 0.014%; p = 0.02) and further increased in areas of unprotected regional I-R (0.444 +/- 0.562%; p = 0.003, vs. control). Myocytes with active caspase 3 were detected after global and regional ischemia. The global ejection fraction did not differ between CPB and regional I-R groups. Conclusions: The use of cardioplegia and CPB efficiently protects the heart from global I-R-induced cardiomyocyte apoptosis during open heart surgery. Copyright (C) 2010 S. Karger AG, Basel