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KMID : 0352519920290010261
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Korea Univercity Medical Journal
1992 Volume.29 No. 1 p.261 ~ p.274
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Effects of Diltiazem Cardioplegia on Myocardial Ultrastructure During Cardiac.
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Abstract
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Current procedure for harvesting human donor hearts for long-term storage
transplantation involves direct infusion of a hypothermic crystalloid cardioplegic solution into the normothermic heart in situ Adjuvant calcium channel blocker theoretically minimizes the calcium influx attendent to potassium induced
cardioplegic
arrest particularly if acceptable levels of cardiac hypothermia are not maintained. The present study assessed the efficacy of diltiazem cardioplegia in ameliorationg perturbations of myocardial preservation during cardiac procurement for
transplantation
The effects of diltiazem cardioplegia on cardiac function and ultrastructure were studied in intraperitoneal heterotopic cardiac transplantation model of Sprague-Dawley rat. Cardioplegic soultion (St. Thomas hopital solution) was used as
preservation
solution.
The degree of damage of donor myocardium during procurement was quantified by means of electron-microscopic examination.
In control group(N=10) donor heart was arrested by cold cardioplegics(St. Thomas hopital solution). Transplantations were performed after 4 hours of preservation with cold cardioplegics. In experimental group donor heart was arrested by cold
diltiazem
cardioplegics(25 ㎍/kg of diltiazem was added to St. Thomas hopital solution). After 4 hours of preservation. transplantation were done. Myocardial preservation status was assessed by cardiac beating score and EM examination of the specimen
obtained
from the free wall of the left ventricle after cardiac transplantation ultrastructures of the left ventricle were evaluated by semi-quantitative analysis of the subendocardial layer of the heart. EM studies of the left ventricle revealed that
Flameng's
Scores for mitochodrial damage were significantly lower in experimental group than were in cotrol group (control group : 1.82. experimental group : 1.46. p<0.05)
These findings suggested that diltiazem cardioplegia conferred better myocardial protection than cold St, Thomas hospital cardioplegia alone.
In conclusion. with use of cold diltiazem cardioplegia, extednded cardiac preservation for transplantation may be obtained successfully.
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