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Mechanoenergetic function and troponin T release following cardioplegic arrest induced by St Thomas' and histidine-tryptophan-ketoglutarate cardioplegia – an experimental comparative study in pigs^,

^a Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, N-9038 Tromsø, Norway
^b Institute of Clinical Medicine, Medical Faculty, University of Tromsø, N-9037 Tromsø, Norway

*Corresponding author. Tel.: +47 77 66 93 56; fax: +47 77 62 82 98.

E-mail address: erling.johan.aarsaether{at}unn.no (E. Aarsæther).

The study compares the single dose histidine-tryptophan-ketoglutarate (HTK) cardioplegia to the repeatedly delivered St Thomas' Hospital Solution (STHS) with respect to preservation of left ventricular mechanoenergetics and leakage of troponin T in a porcine experimental model. Fourteen pigs were randomized to a single infusion of 30 ml/kg HTK cardioplegia (n=7) or 500 ml STHS (n=7) followed by 200 ml after 20 and 40 min. After 1 h of aortic cross-clamping on cardiopulmonary bypass (CPB), the pigs were weaned and the hearts reperfused for 4 h. Stroke work (SW) was determined by a conductance catheter in the left ventricle. Myocardial oxygen consumption (MvO₂) was measured as a function of coronary blood flow and arterial-to-coronary sinus oxygen saturation difference. Troponin T was sampled from the coronary sinus. The slope of the SW-MvO₂ relationship increased by 1.09 (±0.53) in the HTK group compared with 0.33 (±0.70) in the STHS group following ischemia and 4 h of reperfusion (P=0.04). Troponin T was significantly higher in the HTK group compared with the STHS group (P=0.04). Repeatedly delivered STHS gives better preservation of postischemic mechanoenergetic function and lower troponin T release compared with single dose HTK cardioplegia, indicating improved cardioprotection with STHS.

Key Words: Cardiac function; Cardioplegia; Ischemia/reperfusion; Myocardial protection