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Potassium channel openers: are they effective as pretreatment or additives to cardioplegia?
C T Ducko1, E R Stephenson, A M Jayawant
1Department of Surgery, The Milton S. Hershey Medical Center, Penn State Geisinger Health System, Hershey, Pennsylvania, USA.
Background:
This study was designed to test the hypothesis that the potassium channel opener pinacidil (Pin) as a pretreatment (PT) agent or additive to St. Thomas' solution (StT) could enhance myocardial protection.
Methods:
In a parabiotic rabbit Langendorff model, 36 hearts underwent global normothermic ischemia (1 hour) followed by reperfusion (30 minutes). Cardioplegia (50 mL, every 20 minutes) consisted of: StT; PinPT/StT, where Pin PT preceded StT arrest; Pin alone; Pin in StT (Pin/StT); and Pin in low potassium StT. Systolic function after reperfusion (percent recovery of developed pressure) and compliance (diastolic slope from pressure-volume relationship) were measured.
Results:
There was no significant difference between StT and PinPT/StT in percent recovery of developed pressure (51.54% +/- 3.5%, 42.17% +/- 4.0%, respectively) or compliance. Likewise, no significant differences occurred between Pin, StT, Pin/StT, and Pin in low potassium StT in percent recovery of developed pressure (58.99% +/- 4.8%, 51.54% +/- 3.5%, 53.09% +/- 3.2%, 66.43% +/- 7.3%, respectively) or compliance.
Conclusions:
Pin is as effective a cardioplegic agent as StT; however, its use as a pretreatment or additive to traditional and Pin in low potassium StT provided no additional benefit in functional recovery.