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Effect of depolarizing versus non-depolarizing preservation solution on the percentage of myocardial water content in isolated rat hearts / by Michelle L. Garofali.

by Garofali, Michelle L.

Heart -- Transplantation.

Heart -- Preservation.

70 leaves : figures, tables ; 28 cm.

Committee members: Dr. Ronald Gerrits, Dr. Larry Fennigkoh, Dr. Charles Tritt

Introduction -- Background -- Methods and materials -- Results -- Discussion -- References -- Appendix A) Institutional review documents.

Background: Every year approximately 600 patients on the heart transplant list die before a heart becomes available. The significant limitation of heart transplantation is the inability to preserve donor heart beyond 4 hours. In an effort to improve donor preservation, several researchers have focused on the factors that limit this preservation time. One of (the) factors that has been shown to play a role is cardiac edema. This study tested the hypothesis that a depolarizing preservation solution versus non-depolarizing preservation solutions influences myocardial water content formation in isolated rat hearts.

Methods: To investigate this hypothesis, isolated rodent hearts were obtained from twenty-four Sprague-Dawley rats. Rat hearts were flushed (15ml/kg) and stored (30 ml) for 4 hours at 0-4 ̊C in unmodified UW solution (n = 10), or a plasmalyte-A solution containing 0.5mmol/L of Pinacidil (n = 8). Following the 4 hours of hypothermic storage, the hearts were weighed to estimate the wet tissue weight and then dried in a food dehydrator for 6 hours, and weighed to estimate the dry tissue weight. The percentage of myocardial tissue water was a variable calculated to estimate cardiac edema.

Results: The percentage of myocardial water content (%MCW) (mean ± standard deviation) was increased in the Pinacidil study group (80.6 ± 1.0) when compared to the UW solution study group (71.8 ± 4.1), (p<0.001). There was a difference in the %MCW in respect to the experimental day as well. The greatest difference in %MCW was between experiment day 1 (66.4 ± 3.4) and experiment day 3 (79.8 ± 1.6), (p<0.001 between all days).

Discussion: The experiments indicated that UW solution has less influence on myocardial water content following simple preservation and storage than a plasmalyte solution containing pinacidil. The explanation for this finding results is possibly from the difference in osmotic concentrations of the solutions and the effect UW solution has on the efflux of chloride from the myocyte along with water, to prevent cell swelling during preservation and hypothermic storage. The pharmacologic effects that pinacidil has on the inhibition of calcium from vascular smooth muscle may have also contributed to the increase in %MCW by vasodilating the coronary microvasculature and thus, increasing the hydrostatic pressure during flush administration increasing the interstitial fluid flux. UW solution appears to decrease the myocardial edema associated with methods of preservation.

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