HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Francesco Paolo Tritto Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tritto, F. P. Articles by Soler-Soler, J. Search for Related Content PubMed PubMed Citation Articles by Tritto, F. P. Articles by Soler-Soler, J.

J Thorac Cardiovasc Surg 1998;115:709-715
© 1998 Mosby, Inc.

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

Sodium/Hydrogen Exchanger Inhibition Reduces Myocardial Reperfusion Edema After Normothermic Cardioplegia

Supported in part by the European Commission (Biomed II PL 95/1254), Fondo de Investigation Sanitaria de la Seguridad Social (FIS 97/0948), and Hospital General Universitari Vall d'Hebron (RCHG 96/82).

Received for publication Dec. 23, 1996; revisions requested April 15, 1997; revisions received May 12, 1997; accepted for publication August 18, 1997. Address for reprints: David Garcia-Dorado, MD, Laboratorio de Cardiologia, Experimental B, Servicio de Cardiologia, Hospital General Universitari Vall d'Hebron, Pg. Vall d'Hebron 119-129, 08035 Barcelona, Spain.

Abstract

Objective: The hypothesis was that Na⁺/H⁺ exchange occurring during normothermic cardioplegia contributes to the development of myocardial edema during subsequent reperfusion and impairs functional recovery.
Methods: Rat hearts were perfused in a Langendorff apparatus and submitted to 60 minutes of normothermic cardioplegia and 90 minutes of reperfusion. Hearts were allocated to one of four groups (n = 8): inhibition of Na⁺/H⁺ exchanger with HOE642 throughout the whole experiment (HOE group), only during cardioplegia (HOE-C) or during reperfusion (HOE-R), and a control group.
Results: In HOE and HOE-C groups, myocardial water content at the end of reperfusion was lower than in the HOE-R and control groups (526 ± 19 and 533 ± 18 ml/100 gm dry tissue vs 632 ± 25 and 634 ± 17 ml/100 gm dry tissue, respectively, p = 0.001), left ventricular end-diastolic pressure increased less after reperfusion (46.6 ± 9.7 and 63.2 ± 10.0 mm Hg vs 75.1  ± 4.3 mm Hg and 85.7 ± 8.9 mm Hg, respectively, p = 0.006), and recovery of left ventricular developed pressure was better (46.7% and 45.8% vs 4.5% and 9.8%, p = 0.048). Relative to the control group, total lactate dehydrogenase release during reperfusion was reduced by 80.2%, 69.3% and 36% in HOE, HOE-C, and HOE-R groups, respectively.
Conclusion: Inhibition of the Na⁺/H⁺ exchange during normothermic cardioplegia reduces myocardial edema and necrosis during subsequent reperfusion, improving functional recovery. Inhibition of Na⁺/H⁺ exchange during reperfusion only has a much smaller effect. (J Thorac Cardiovasc Surg 1998;115:709-15)

This article has been cited by other articles:

				J. S. Corvera, Z.-Q. Zhao, L. S. Schmarkey, S. L. Katzmark, J. M. Budde, C. D. Morris, T. Ehring, R. A. Guyton, and J. Vinten-Johansen Optimal dose and mode of delivery of Na+/H+ exchange-1 inhibitor are critical for reducing postsurgical ischemia-reperfusion injury Ann. Thorac. Surg., November 1, 2003; 76(5): 1614 - 1622. [Abstract] [Full Text] [PDF]

				S. A. F. Tulner, R. J. M. Klautz, G. L. van Rijk-Zwikker, F. H. M. Engbers, J. J. Bax, J. Baan, E. E. van der Wall, R. A. Dion, and P. Steendijk Perioperative Assessment of Left Ventricular Function by Pressure-Volume Loops Using the Conductance Catheter Method Anesth. Analg., October 1, 2003; 97(4): 950 - 957. [Abstract] [Full Text] [PDF]

				M. Castella, G. D. Buckberg, and Z. Tan Blood cardioplegic protection in profoundly damaged hearts: role of Na+-H+ exchange inhibition during pretreatment or during controlled reperfusion supplementation Ann. Thorac. Surg., April 1, 2003; 75(4): 1238 - 1245. [Abstract] [Full Text] [PDF]

				C. S. Cox Jr, H. Sauer, S. J. Allen, L. M. Buja, and G. A. Laine Sodium/hydrogen-exchanger inhibition during cardioplegic arrest and cardiopulmonary bypass: An experimental study J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 959 - 966. [Abstract] [Full Text] [PDF]

				Y. Toyoda, S. Khan, W. Chen, R. A. Parker, S. Levitsky, and J. D. McCully Effects of NHE-1 inhibition on cardioprotection and impact on protection by K/Mg cardioplegia Ann. Thorac. Surg., September 1, 2001; 72(3): 836 - 843. [Abstract] [Full Text] [PDF]

				E. Kevelaitis, A. Oubenaissa, C. Mouas, J. Peynet, and P. Menasche Ischemic preconditioning with opening of mitochondrial adenosine triphosphate-sensitive potassium channels or Na+/H+ exchange inhibition: Which is the best protective strategy for heart transplants? J. Thorac. Cardiovasc. Surg., January 1, 2001; 121(1): 0155 - 162. [Abstract] [Full Text] [PDF]