Optimizing probucol administration to preserve left ventricular compliance after reperfusion injury in the heterotopic rat heart isograft

Oral treatment with probucol in a pharmacological dose has no beneficial effects on mortality in chronic ischemic heart failure after large myocardial infarction in rats

Cardiac remodeling after myocardial infarction is in part triggered and maintained by reactive oxygen species. Antioxidants such as probucol have shown positive short-term effects on these cardiac interstitial changes in different experimental models after intraperitoneal administration or after per-oral administration with a long pre-treatment period or in high doses. In this study, the long-term effects on mortality and cardiac remodeling were examined after induction of a large myocardial infarction in a clinical daily-life-like setting. Male Lewis rats were randomized to the study groups. Large anterolateral myocardial infarctions were induced or sham operations performed. The oral treatment was started after 48 h either with probucol or placebo after myocardial infarction and with placebo after sham operation. Induction of large myocardial infarctions led to changes of the left ventricular stiffness constants, a dilatation of the left ventricle and an increased interstitial fibrosis in the remote non-infarcted part. These changes were in tendency, but not significantly, reversed after treatment with probucol. The 6-month survival rates were 53.1% in the group probucol-myocardial infarction, 43.2% in the group placebo-myocardial infarction and 100% in the group after sham operation. There were no significant differences at Kaplan-Meier analysis between the groups after myocardial infarctions. Oral treatment with the antioxidant probucol started after myocardial infarction in a pharmacological dose does not have favourable effects on the long-term mortality in the chronic ischemic heart failure model in the rat.

Protective role of 3-nitro-N-methyl-salicylamide on isolated rat heart during 4 hours of cold storage and reperfusion

OBJECTIVE

Cardiac ischemia/reperfusion (I/R) injury, a necessary consequence of transplantation, is probably related to the formation of reactive oxygen species (ROS). The ROS burst within the first moments of reperfusion is associated with injury, continuously generate O2- at about 3% to 5% of total O2 consumption owing to electron leak by mitochondrial oxidoreductases, especially complexes I and III. 3-nitro-N-methyl-salicylamide (NNMS) displays inhibitory effects on succinate-cytochrome C reductase, but also reduces effects on creation of O2- radical and H2O2 by isolated rat mitochondria. Presumably NNMS inhibits electron leakage from the mitochondrial respiratory chain. We investigated effect of NNMS on heart protection after hypothermic ischemia.

METHODS

A Langendorff-prepared rat heart model was employed after the heart had been preserved for 4 hours under hypothermic conditions of ischemia with subsequent reperfusion/rewarming for 60 minutes.

RESULTS

The group of hearts treated with NNMS showed increased recovery of heart function compared with a group of mEC. The lactate dehydrogenase (LDH) activity in coronary flow (CF) by hearts treated with NNMS was lower than that with mECs, as was the content of malonedialdehyde (MDA) and conjugated diene (CD).

CONCLUSIONS

NNMS improved heart physiology after reperfusion following 4 hours of hypothermic ischemia.

Vitamin E in heart transplantation: effects on cardiac gene expression

BACKGROUND

Oxidative stress, as induced in organ storage or upon reperfusion, may impact the quality of the transplant. Vitamin E, a radical scavenger, may alleviate stress associated with cardiac surgery.

METHODS

We investigated the effects of vitamin E treatment in a rat heart transplantation model and link dose to tissue and plasma vitamin E levels. We further studied expression of 39 genes coding for stress markers, proinflammatory cytokines, apoptotic pathways, structural proteins, extracellular matrix, cardiomyocyte specific transcription factors, and metabolic pathways to obtain information on the benefits of vitamin E treatment.

RESULTS

Treatment of donor and recipient animals significantly increased blood and heart tissue vitamin E levels (P<0.05). We observed a significant reduction (P<0.05) of genes coding for oxygen detoxification (e.g., SOD), as well as expression of the adhesion molecules, ICAM-1 and PECAM-1 (P<0.05). Notably, transcript levels of the stress marker atrial natriuretic peptide (ANP) was reduced (P<0.05), whereas expression of cardiac and skeletal actin was increased. Further, expression of the disease markers beta-MHC and VCAM-1 was repressed (P<0.05), as was expression of the myocyte enhancer factor MEF2c. Noteworthy, vitamin E repressed expression of SP1 and c-fos transcript level. Specifically, their expression is elevated in reperfusion injured tissue.

CONCLUSIONS

Based on transcript profiling, we propose a novel role of vitamin E in transplant surgery. Our findings warrant further studies to explore its clinical application.

Na+/H+ exchange inhibition and antioxidants lack additive protective effects after reperfusion injury in the working heterotopic rat heart isograft

BACKGROUND

The utility of combining strategies of myocardial protection was studied in intact rat hearts subjected to 1 hour of ischemia and 40 minutes blood reperfusion.

METHODS

Lewis rats (n = 48) were divided into 4 transplant groups. Twenty-four hearts were arrested by coronary perfusion with hypothermic Celsior solution at 60 mm Hg. The aortic valve was punctured to introduce volume into the left ventricle (LV), and the hearts were abdominally isografted. Animals were either given both the antioxidant probucol (300 mg/kg) and the sodium-hydrogen exchange inhibitor cariporide (5 mg/kg) (CP; n = 6), just cariporide (CAR; n = 6), just probucol (PROB; n = 6), or neither drug (CON; n = 6). After 40 minutes of blood reperfusion, transplanted hearts were rearrested. The control recipients' native hearts (native; n = 6) were also arrested. Postmortem LV compliance relations and myocardial water content (MWC) were measured.

RESULTS

Grafts protected by probucol were significantly more compliant than controls and significantly less compliant than grafts protected by cariporide alone and with both cariporide and probucol (p = 0.0001, analysis of variance). Compliance relations for CP overlapped those for CAR. All grafts were less compliant than natives. MWC was significantly greater in controls and PROB than in natives.

CONCLUSIONS

Pretreatment with cariporide in the setting of ischemia-reperfusion injury provides greater protection against the development of diastolic abnormalities than probucol when Celsior solution is used for both arrest and preservation. In this model, there is no advantage to combining the drugs, supporting the hypothesis that there is an overlapping mechanism of protection.