Optimal level of hypothermia for prolonged myocardial protection assessed by 31P nuclear magnetic resonance

Subzero 24-hr nonfreezing rat heart preservation: a novel preservation method in a variable magnetic field

BACKGROUND

A new supercooling system using a variable magnetic field has been recently developed. Subzero nonfreezing preservation has been believed to be a beneficial method because of the lower metabolic rate. The purpose of this study was to evaluate the hemodynamic and metabolic effects of rat heart preservation in a variable magnetic field without cryoprotectants.

METHODS

Rat hearts were perfused ex vivo for 120 min after 24-hr preservation in two groups (n=6 each): (1) conventional storage group, in which the hearts were stored at 4°C, and (2) the subzero group, in which the hearts were preserved at -3°C in a variable magnetic field.

RESULTS

Reperfusion cardiac performance after preservation was significantly preserved in the subzero group compared with the conventional group with respect to heart rate, coronary flow, the peak positive dP/dt, and the peak negative dP/dt (P<0.05). Edema after reperfusion was significantly decreased (P<0.05), and the adenosine triphosphate level was higher in the subzero group (P<0.05).

CONCLUSIONS

The rat hearts preserved in a variable magnetic field at -3°C showed better hemodynamic and metabolic performance than those preserved using conventional storage at 4°C.

Temperature dependence of monovalent cation fluxes in isolated rat hearts: a magnetic resonance study

Ion flux studies were performed on Langendorff-perfused rat hearts using 87Rb, 7Li and 23Na NMR at 36, 20 and 10 degreesC, and at constant extracellular pH (7.40). Using 31P NMR, the intracellular pH was estimated and the high energy phosphate content monitored. Compared to 36 degreesC (k=0.044+/-0.015 min-1), our measurements showed incomplete Rb+ efflux with a dramatically (5-fold) increased rate constant, k, at 20 degreesC, k=0.238+/-0.080 min-1. 5 microM glibenclamide, a KATP-channel inhibitor, completely depressed the hypothermia-activated Rb+ efflux at this temperature (k=0.052+/-0. 018 min-1). 7Li NMR efflux studies on KCl-arrested hearts at 20 degreesC also showed an increase (3-fold) in efflux rate constant: k=0.090+/-0.003 min-1 relative to its value at 36 degreesC. At 10 degreesC, both Rb+ and Li+ showed efflux rate constants similar to those observed at 36 degreesC, k=0.071+/-0.016 min-1 and k=0.050+/-0. 005 min-1, respectively, and the washout was complete. 31P NMR at 36, 20 and 10 degreesC indicated cytosolic alkalinization at pH values of 7.05, 7.21 and 7.40, respectively. The ion transport data could be interpreted in terms of a myocyte model allowing for temperature-dependent changes in transport coefficients. The incomplete efflux of Rb+ at 20 degreesC may indicate the existence of a mitochondrial Rb+-pool with a very low Rb+ permeability for efflux. These findings correlate with previously observed membrane phase transitions in these systems.

Observation of two inorganic phosphate NMR resonances in the perfused hypothermic rat heart

The effect of hypothermia on isolated perfused rat hearts was studied with 31P NMR. Hearts were continuously perfused with phosphate-free Krebs-Henseleit buffer while the perfusate temperature was adjusted. Perfusate pH was kept at 7.40 +/- 0.02 throughout the experiments. Using the chemical shift difference between PCr and Pi the intracellular pH was estimated. At 36, 20, and 10 degreesC a cytosolic alkalinization at a pH of 7.05 +/- 0.04, 7.21 +/- 0.05, and 7.40 +/- 0.03 was observed, respectively. At 10 degreesC two Pi resonances were observed with a separation of 0.25 ppm. This resonance corresponded to a Pi resonance of a cellular compartment with a local pH of 7.78 +/- 0.06, likely mitochondrial. This additional resonance disappeared upon warming of the hearts back to 36 degreesC.

The influence of temperature on metabolic and cellular protection of the heart during long-term ischemia: a study using P-31 magnetic resonance spectroscopy and biochemical analyses

We have compared the influence of two different cold temperatures (below 10 degreesC) for cardiac ischemia by measuring a large variety of hemodynamic and metabolic parameters during ischemia and reflow. Isolated isovolumic rat hearts were arrested with a preservation solution which was developed in our laboratory and then submitted to 5 h of cold storage (4 degreesC, group I; and 7.5 degreesC, group II) in the same solution. After an additional period of 50 min of ischemia at 15 degreesC with intermittent cardioplegic infusion, hearts were reperfused for 60 min at 37 degreesC. Function was assessed during the control period and reflow. High-energy phosphates and intracellular pH were followed by 31P magnetic resonance spectroscopy. Analyses of metabolites and enzymes were performed by biochemical assays and HPLC in coronary effluents and in freeze-clamped hearts to assess cellular integrity. The energetic pool was better preserved at 4 degreesC during ischemia (ATP at the end of 4 degreesC ischemia, 59 +/- 7% in group I vs 31 +/- 5% in group II, P < 0.01) and reflow (P < 0.05) but membrane protection was higher when increasing the temperature to 7.5 degreesC (reduction of creatine kinase leakage, 89 +/- 16 IU/min in group I vs 51 +/- 5 IU/min in group II, P < 0.05). As a result, functional recovery, represented by the rate pressure product, was higher in hearts preserved at 7.5 degreesC (52 +/- 6% recovery in group I vs 77 +/- 7% in group II at the end of reflow, P < 0.05). Altogether, cold storage at 7.5 degreesC provides a better protection than storage at 4 degreesC.