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[Improved protection of hypertrophied myocardium in ischemia by histidine buffer cardioplegia]

K Takeuchi1, K Takashima, S Suzuki

  • 1Division of Cardiothoracic Surgery, University of Pittsburgh, School of Medicine, USA.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|June 1, 1995
PubMed

Insights

Histidine-containing cardioplegia effectively preserves hypertrophied hearts during surgery. This solution promotes anaerobic glycolysis, maintaining energy phosphates and cardiac function better than standard solutions.

Area of Science:

  • Cardiology
  • Biochemistry
  • Physiology

Context:

  • Pressure overload hypertrophy is a significant risk factor for open-heart surgery.
  • Hypertrophied hearts experience accelerated loss of high-energy nucleotides and increased lactate accumulation.
  • Preserving myocardial function during ischemia is critical for surgical outcomes.

Purpose:

  • To evaluate the efficacy of histidine-containing cardioplegia (HB) in preserving hypertrophied myocardium.
  • To determine if HB promotes anaerobic glycolysis for improved cardiac preservation.
  • To compare HB with high potassium Krebs buffer solution (KCl) in a rabbit model.

Summary:

  • Hypertrophied rabbit hearts underwent 40 minutes of 37°C ischemia followed by reperfusion.
  • Hearts treated with HB showed significantly higher phosphocreatine, intracellular pH, and lactate production compared to the KCl group.
  • Lactate production indicated enhanced anaerobic glycolysis in the HB group.

Impact:

  • Histidine-containing cardioplegia promotes anaerobic glycolysis, crucial for maintaining high-energy phosphates.
  • HB treatment leads to better recovery of cardiac function in hypertrophied myocardium post-ischemia.
  • This finding suggests HB as a superior cardioplegic solution for patients with pressure overload hypertrophy.

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