Abstract
This study examined the effect of betamethasone on myocardial viability of reperfused isolated canine hearts following a 6-h hypothermic cardioplegia. The dogs were divided into two groups: group I (n = 9) received nondepolarizing cardioplegia containing betamethasone 250 mg/l while group II (n = 7) was administered cardioplegia without betamethasone. The myocardial concentrations of calcium, ATP, ADP, total adenine nucleotide, cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) were identical in the two groups throughout the experiment. The coronary sinus plasma concentrations of MB fraction off creatine kinase (MB-CK), cAMP and cGMP after 2 h of reperfusion were significantly lower in group I than in group II. The myocardial mitochondrial ultrastructure, as assessed by semiquantitative morphometry, was found to be significantly better preserved in group I than in group II at the end of both preservation and reperfusion. In addition, the left ventricular end-systolic pressure volume relation (ESPVR) showed a higher slope and lower intercept in group I than in group II. These results suggest that the addition of betamethasone to nondepolarizing cold cardioplegia enhances myocardial protection via membrane stabilization without affecting the adenine nucleotide metabolism.
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Spath JA Jr, David LL, Lefer AM (1974) Protective action of methylprednisolone on the myocardium during experimental myocardial ischemia in the cat. Circ Res 35:44–51
Sunamori M (1978) Protective effect of betamethasone on subendocardial ischemia after cardiopulmonary bypass. J Cardiovasc Surg 19:291–310
Sunamori M, Harrison CE Jr (1980) Effect of betamethasone on mitochondrial oxidative phosphorylation in ischemic canine myocardium. Mayo Clin Proc 55:377–382
Jeevanandam V, Auteri JS, Marboe C, Hsu D, Sanchez JA, Smith CR, Rose EA (1991) Extending the limits of donor heart preservation: A trial with University of Wisconsin solution. Transplant Proc 23:697–698
Miyamoto H, Sunamori M, Suzuki A (1993) Comparison of a nondepolarizing solution in intermittent injection for donor heart preservation with a single-flushed UW solution. Transplant Int 6:63–68
Nayler WG, Seabra-Gomes (1976) The effect of methylprednisolone on hypoxic heart muscle. Cardiovasc Res 10:349–353
Okuda M, Young KR Jr, Lefer AM (1976) Localization of glucocorticoid uptake in normal and ischemic myocardial tissue of isolated perfused cat heart. Circ Res 39:640–646
Roberts R, DeMello V, Sobel BE (1976) Deleterious effects of methylprednisolone in patients with myocardial infarction. Circulation 53:I–204-I–206
Carr FK, Goldfarb RD (1980) Ischemia-induced canine myocardial lysosome labilization: the role of endogenous prostagrandins and cyclic nucleotides. Exp Mol Pathol 33:36–42
McMurchie EJ, Raison JK, Cairncross KD (1973) Temperature-induced phase changes in membranes of heart: A contrast between the thermal responses of poikilotherms and homeotherms. Comp Biochem Physiol 44:1017–1026
Martin DR, Scott DF, Downer GL, Belzer FO (1972) Primary causes of unsuccessful liver and heart preservation: Cold sensitivity of the ATPase system. Ann Surg 175:111–117
Sunamori M, Sultan I, Shirai T, Suzuki A (1992) The significant role of membrane stabilization in hypothermic cardioplegic preservation in a canine experimental model. Transplant Int 5[Suppl 1]:S411-S416
Henry RJ, Cannon DC, Winkelman JW (1974) Determination of calcium by atomic absorption spectrophotometry. In: Henry RJ, Cannon DC, Winkelman JW (eds) Clinical chemistry, principles and techniques. 2nd edn. Harper and Row, Baltimore, p 657
Sunamori M, Trout RG, Kaye MP, Harrison CE Jr (1978) Quantitative evaluation of myocardial ultrastructure following hypothermic anoxic arrest. J Thorac Cardiovasc Surg 76:518–527
Piran U, Kohn DW, Uretsky LS, Bernier D, Barlow EH, Niswander CA, Stastny M (1987) Immunochemiluminometric assay of creatine kinase MB with a monoclonal antibody to the MB isozyme. Clin Chem 33:1517–1520
Steiner AL, Pagliara EA, Chase LR, Kipnis DM (1972) Radioimmunoassay for cyclic nucleotides. 11. cAMP and cGMP in mammalian tissues and body fluids. J Biol Chem 247:1114–1120
Drinkwater DC, Laks H (1991) Donor Procurement and Management: Donor organ preservation. In: Kapoor AS, Laks H, Schroeder JS, Yacoub MH (eds) Cardiomyopathies and heart-lung transplanation. McGraw-Hill, New York, p 179
Fragomeni LS, Rogers G, Kaye MP (1990) Donor identification and organ procurement for cardiac transplantation. In: Thompson ME (ed) Cardiac transplantation. F.A. Davis, Philadelphia, pp 121–122
Sunamori M, Shirai T, Miyamoto H, Suzuki A (1992) Effect of membrane potencial induced by solution for donor heart preservation on myocardial viability and functional recovery (abstract). J Mol Cell Cardiol 24[Suppel I]:S118
Wicomb WN, Hill JD, Collins GM (1989) Comparison of cardioplegic and UW solutions for short-term rabbit heart preservation. Transplantation 47:733–734
Rosenfeldt FL, Hearse DJ, Cankovic-Darracott S, Braimbridge MV (1980) The additive protective effects of hypothermia and chemical cardioplegia during ischemic cardiac arrest in the dog. J Thorac Cardiovasc Surg 79:29–38
Flaherty FT, Schaff HV, Goldman RA, Gott VL (1979) Metabolic and functional effects of progressive degrees of hypothermia during global ischemia. Am J Physiol 236:H839-H845
Engelman RM, Prasad MR, Ronson JA, Breyer RH, Bagchi M, Das DK (1989) Steroid-induced myocardial preservation is associated with decreased cell membrane microviscosity. Circulation 80[Suppl III]:III–36-III–43
Jefferson TA, Glenn TM, Martin JB, Lefer AM (1971) Cardiovascular and lysosomal actions of corticosteroids in the intact dog. Proc Soc Exp Biol Med 136:276–280
Replogle RL, Gazzaniga AB, Cross RE (1966) Use of corticosteroids during cardiopulmonary bypass. Circ Res 33[Suppl 1]:86–92
Ignarro LJ, George WJ (1974) Hormonal control of lysosomal enzyme release from human neutrophils: elevations of cyclic nucleotide levels by autonomic neurohormones. Proc Natl Acad Sci USA 715:2027–2031
Alto LE, Dhalla NS (1979) Myocardial cation contents during induction of calcium paradox. Am J Physiol 237:H13-H19
Mattiazi A, Nilson E (1976) The influence of temperature on the tissue course of the mechanical activity in rabbit papillary muscle. Acta Physiol 97:310–318
Leaf A (1973) Cell swelling. A factor in ischemic tissue injury. Circulation 48:455–458
Ignarro LJ, Krassikoff N, Slywka J (1973) Release of enzymes from a rat liver lysosome fraction: inhibition by catecholamines and cyclic 3′,5′-adenosine monophosphate, stimulation by cholinergic agents and cyclic 3′,5′-guanosine monophosphate. J Pharmacol Exp Ther 186:86–89
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Miyamoto, H., Sunamori, M., Yoshida, T. et al. The effect of betamethasone on myocardial viability during cold cardioplegia in canine donor heart preservation. Surg Today 24, 449–455 (1994). https://doi.org/10.1007/BF01427039
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DOI: https://doi.org/10.1007/BF01427039