Inhibition of neutrophil adherence improves postischemic ventricular performance of the neonatal heart

Ian Wilson, A. Marc Gillinov, William E. Curtis, Joseph DiNatale, Ronald M. Burch, Timothy J. Gardner, Duke E. Cameron

Research output: Contribution to journalArticle

Abstract

Background. Reduction of the leukocyte population during postischemic coronary reperfusion results in decreased neutrophil-mediated tissue injury. However, the importance of leukocyte adhesion to coronary endothelium for postischemic ventricular dysfunction after global hypothermic myocardial ischemia is unknown. Neutrophil integrins (CD11b/CD18) upregulate in response to cardiopulmonary bypass and ischemic stress, and their role in generating postoperative ventricular dysfunction was examined in this study. Methods and Results. An in vivo, in situ model of neonatal cardiac surgery was established in which neutrophil adherence was manipulated by administering NPC 15669 (an inhibitor of neutrophil CD11b/CD18 surface receptor upregulation). Seventeen 3- to 5-day-old piglets (8 controls and 9 NPC 15669-treated animals) were instrumented with a coronary sinus catheter, sonomicrometry crystals across the short axis of the left ventricle (LV), and a micromanometer positioned in the LV. Hearts were subjected to 90 minutes of hypothermic ischemia after a single dose of cold crystalloid cardioplegia. Myocardial granulocyte accumulation during ischemia and reperfusion was reduced in NPC animals compared with controls (myeloperoxidase activity, 43.4±2.6 and 75.8±6.3 μmol/10 mg tissue, respectively; P≤.005). This was associated with a reduction in coronary vascular resistance in NPC animals compared with controls (P≤.02) and decreased release of myocardial creatine phosphokinase throughout reperfusion (P≤.05). NPC animals demonstrated an improved preservation of the end-systolic pressure-volume relation after discontinuation of cardiopulmonary bypass (71±6% and 96±6% at 60 minutes, respectively; P≤.05). There was no difference in ventricular compliance between groups. Conclusions. These data demonstrate that inhibition of neutrophil CD11b/CD18 surface adherence receptor upregulation reduces granulocyte accumulation in myocardium after hypothermic global ischemia, reduces myocyte damage, and improves ventricular systolic function.

Original languageEnglish (US)
Pages (from-to)372-379
Number of pages8
JournalCirculation
Volume88
Issue number5 PART 2
StatePublished - Nov 1993

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Neutrophils
Ventricular Dysfunction
Up-Regulation
Ischemia
Cardiopulmonary Bypass
Granulocytes
Reperfusion
Heart Ventricles
Leukocytes
Induced Heart Arrest
Myocardial Reperfusion
Ventricular Function
Coronary Sinus
Creatine Kinase
Integrins
Vascular Resistance
Muscle Cells
Peroxidase
Thoracic Surgery
Compliance

Keywords

  • Granulocytes
  • Integrin

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Wilson, I., Gillinov, A. M., Curtis, W. E., DiNatale, J., Burch, R. M., Gardner, T. J., & Cameron, D. E. (1993). Inhibition of neutrophil adherence improves postischemic ventricular performance of the neonatal heart. Circulation, 88(5 PART 2), 372-379.

Inhibition of neutrophil adherence improves postischemic ventricular performance of the neonatal heart. / Wilson, Ian; Gillinov, A. Marc; Curtis, William E.; DiNatale, Joseph; Burch, Ronald M.; Gardner, Timothy J.; Cameron, Duke E.

In: Circulation, Vol. 88, No. 5 PART 2, 11.1993, p. 372-379.

Research output: Contribution to journalArticle

Wilson, I, Gillinov, AM, Curtis, WE, DiNatale, J, Burch, RM, Gardner, TJ & Cameron, DE 1993, 'Inhibition of neutrophil adherence improves postischemic ventricular performance of the neonatal heart', Circulation, vol. 88, no. 5 PART 2, pp. 372-379.
Wilson I, Gillinov AM, Curtis WE, DiNatale J, Burch RM, Gardner TJ et al. Inhibition of neutrophil adherence improves postischemic ventricular performance of the neonatal heart. Circulation. 1993 Nov;88(5 PART 2):372-379.
Wilson, Ian ; Gillinov, A. Marc ; Curtis, William E. ; DiNatale, Joseph ; Burch, Ronald M. ; Gardner, Timothy J. ; Cameron, Duke E. / Inhibition of neutrophil adherence improves postischemic ventricular performance of the neonatal heart. In: Circulation. 1993 ; Vol. 88, No. 5 PART 2. pp. 372-379.
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abstract = "Background. Reduction of the leukocyte population during postischemic coronary reperfusion results in decreased neutrophil-mediated tissue injury. However, the importance of leukocyte adhesion to coronary endothelium for postischemic ventricular dysfunction after global hypothermic myocardial ischemia is unknown. Neutrophil integrins (CD11b/CD18) upregulate in response to cardiopulmonary bypass and ischemic stress, and their role in generating postoperative ventricular dysfunction was examined in this study. Methods and Results. An in vivo, in situ model of neonatal cardiac surgery was established in which neutrophil adherence was manipulated by administering NPC 15669 (an inhibitor of neutrophil CD11b/CD18 surface receptor upregulation). Seventeen 3- to 5-day-old piglets (8 controls and 9 NPC 15669-treated animals) were instrumented with a coronary sinus catheter, sonomicrometry crystals across the short axis of the left ventricle (LV), and a micromanometer positioned in the LV. Hearts were subjected to 90 minutes of hypothermic ischemia after a single dose of cold crystalloid cardioplegia. Myocardial granulocyte accumulation during ischemia and reperfusion was reduced in NPC animals compared with controls (myeloperoxidase activity, 43.4±2.6 and 75.8±6.3 μmol/10 mg tissue, respectively; P≤.005). This was associated with a reduction in coronary vascular resistance in NPC animals compared with controls (P≤.02) and decreased release of myocardial creatine phosphokinase throughout reperfusion (P≤.05). NPC animals demonstrated an improved preservation of the end-systolic pressure-volume relation after discontinuation of cardiopulmonary bypass (71±6{\%} and 96±6{\%} at 60 minutes, respectively; P≤.05). There was no difference in ventricular compliance between groups. Conclusions. These data demonstrate that inhibition of neutrophil CD11b/CD18 surface adherence receptor upregulation reduces granulocyte accumulation in myocardium after hypothermic global ischemia, reduces myocyte damage, and improves ventricular systolic function.",
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AU - Wilson, Ian

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AU - Gardner, Timothy J.

AU - Cameron, Duke E.

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AB - Background. Reduction of the leukocyte population during postischemic coronary reperfusion results in decreased neutrophil-mediated tissue injury. However, the importance of leukocyte adhesion to coronary endothelium for postischemic ventricular dysfunction after global hypothermic myocardial ischemia is unknown. Neutrophil integrins (CD11b/CD18) upregulate in response to cardiopulmonary bypass and ischemic stress, and their role in generating postoperative ventricular dysfunction was examined in this study. Methods and Results. An in vivo, in situ model of neonatal cardiac surgery was established in which neutrophil adherence was manipulated by administering NPC 15669 (an inhibitor of neutrophil CD11b/CD18 surface receptor upregulation). Seventeen 3- to 5-day-old piglets (8 controls and 9 NPC 15669-treated animals) were instrumented with a coronary sinus catheter, sonomicrometry crystals across the short axis of the left ventricle (LV), and a micromanometer positioned in the LV. Hearts were subjected to 90 minutes of hypothermic ischemia after a single dose of cold crystalloid cardioplegia. Myocardial granulocyte accumulation during ischemia and reperfusion was reduced in NPC animals compared with controls (myeloperoxidase activity, 43.4±2.6 and 75.8±6.3 μmol/10 mg tissue, respectively; P≤.005). This was associated with a reduction in coronary vascular resistance in NPC animals compared with controls (P≤.02) and decreased release of myocardial creatine phosphokinase throughout reperfusion (P≤.05). NPC animals demonstrated an improved preservation of the end-systolic pressure-volume relation after discontinuation of cardiopulmonary bypass (71±6% and 96±6% at 60 minutes, respectively; P≤.05). There was no difference in ventricular compliance between groups. Conclusions. These data demonstrate that inhibition of neutrophil CD11b/CD18 surface adherence receptor upregulation reduces granulocyte accumulation in myocardium after hypothermic global ischemia, reduces myocyte damage, and improves ventricular systolic function.

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