Progress towards a more physiologic approach to donor heart preservation: The advantages of hyperpolarized arrest

Michael D. Diodato, Nirav R. Shah, Sunil M. Prasad, Erica L. Racen, Shinichi Mizutani, Jennifer Lawton, Ralph J. Damiano

Research output: Contribution to journalArticle

Abstract

Background: The University of Wisconsin (UW) solution is the gold standard for heart preservation but has limitations in terms of both duration and adequacy of protection. Our laboratory has been interested in a more physiologic approach to heart preservation by maintaining the heart at its resting membrane potential (hyperpolarized arrest) with the KATP channel agonist pinacidil. This study compared our extracellular solution (WashU) with the UW intracellular depolarizing solution and quantified the protective effect of pinacidil in both solutions. Methods: Thirty-two rabbit hearts received 1 of 4 solutions in a crystalloid-perfused Langendorff apparatus: (1) UW, (2) WashU containing 0.5 mmol/liter pinacidil, (3) UW with 0.5 mmol/liter pinacidil, or (4) WashU without pinacidil. Thirty minutes of perfusion was followed by data acquisition consisting of left ventricular pressure-volume curves generated by inflating an intraventricular balloon. All hearts were placed in cold storage for 8 hours, followed by 1 hour of reperfusion before data acquisition. Results: Post-ischemic developed pressure (DP) was better preserved by WashU (76.8% ± 3.8%) than by UW (48.3% ± 2.5%). Diastolic compliance was better preserved by WashU (239.9% ± 77.2%) compared with UW (711.1% ± 193.1%). Removing pinacidil from our solution resulted in decreased DP (46.6% ± 3.2%) and diastolic compliance (688.8% ± 158.2%) Adding pinacidil to UW had a limited effect on DP and compliance. Conclusions: Our results support the superiority of the WashU hyperpolarizing solution for heart preservation over UW. Pinacidil was beneficial in maintaining cardiac function and compliance. This benefit was not observed when pinacidil was placed into the UW depolarizing solution.

Original languageEnglish (US)
Pages (from-to)1362-1368
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume24
Issue number9
DOIs
StatePublished - Sep 2005
Externally publishedYes

Fingerprint

Pinacidil
Compliance
Pressure
KATP Channels
Ventricular Pressure
Membrane Potentials
Reperfusion
Perfusion
Rabbits

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Progress towards a more physiologic approach to donor heart preservation : The advantages of hyperpolarized arrest. / Diodato, Michael D.; Shah, Nirav R.; Prasad, Sunil M.; Racen, Erica L.; Mizutani, Shinichi; Lawton, Jennifer; Damiano, Ralph J.

In: Journal of Heart and Lung Transplantation, Vol. 24, No. 9, 09.2005, p. 1362-1368.

Research output: Contribution to journalArticle

Diodato, Michael D. ; Shah, Nirav R. ; Prasad, Sunil M. ; Racen, Erica L. ; Mizutani, Shinichi ; Lawton, Jennifer ; Damiano, Ralph J. / Progress towards a more physiologic approach to donor heart preservation : The advantages of hyperpolarized arrest. In: Journal of Heart and Lung Transplantation. 2005 ; Vol. 24, No. 9. pp. 1362-1368.
@article{4e591115a61544378ef6bba328a7ae79,
title = "Progress towards a more physiologic approach to donor heart preservation: The advantages of hyperpolarized arrest",
abstract = "Background: The University of Wisconsin (UW) solution is the gold standard for heart preservation but has limitations in terms of both duration and adequacy of protection. Our laboratory has been interested in a more physiologic approach to heart preservation by maintaining the heart at its resting membrane potential (hyperpolarized arrest) with the KATP channel agonist pinacidil. This study compared our extracellular solution (WashU) with the UW intracellular depolarizing solution and quantified the protective effect of pinacidil in both solutions. Methods: Thirty-two rabbit hearts received 1 of 4 solutions in a crystalloid-perfused Langendorff apparatus: (1) UW, (2) WashU containing 0.5 mmol/liter pinacidil, (3) UW with 0.5 mmol/liter pinacidil, or (4) WashU without pinacidil. Thirty minutes of perfusion was followed by data acquisition consisting of left ventricular pressure-volume curves generated by inflating an intraventricular balloon. All hearts were placed in cold storage for 8 hours, followed by 1 hour of reperfusion before data acquisition. Results: Post-ischemic developed pressure (DP) was better preserved by WashU (76.8{\%} ± 3.8{\%}) than by UW (48.3{\%} ± 2.5{\%}). Diastolic compliance was better preserved by WashU (239.9{\%} ± 77.2{\%}) compared with UW (711.1{\%} ± 193.1{\%}). Removing pinacidil from our solution resulted in decreased DP (46.6{\%} ± 3.2{\%}) and diastolic compliance (688.8{\%} ± 158.2{\%}) Adding pinacidil to UW had a limited effect on DP and compliance. Conclusions: Our results support the superiority of the WashU hyperpolarizing solution for heart preservation over UW. Pinacidil was beneficial in maintaining cardiac function and compliance. This benefit was not observed when pinacidil was placed into the UW depolarizing solution.",
author = "Diodato, {Michael D.} and Shah, {Nirav R.} and Prasad, {Sunil M.} and Racen, {Erica L.} and Shinichi Mizutani and Jennifer Lawton and Damiano, {Ralph J.}",
year = "2005",
month = "9",
doi = "10.1016/j.healun.2004.10.011",
language = "English (US)",
volume = "24",
pages = "1362--1368",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",
number = "9",

}

TY - JOUR

T1 - Progress towards a more physiologic approach to donor heart preservation

T2 - The advantages of hyperpolarized arrest

AU - Diodato, Michael D.

AU - Shah, Nirav R.

AU - Prasad, Sunil M.

AU - Racen, Erica L.

AU - Mizutani, Shinichi

AU - Lawton, Jennifer

AU - Damiano, Ralph J.

PY - 2005/9

Y1 - 2005/9

N2 - Background: The University of Wisconsin (UW) solution is the gold standard for heart preservation but has limitations in terms of both duration and adequacy of protection. Our laboratory has been interested in a more physiologic approach to heart preservation by maintaining the heart at its resting membrane potential (hyperpolarized arrest) with the KATP channel agonist pinacidil. This study compared our extracellular solution (WashU) with the UW intracellular depolarizing solution and quantified the protective effect of pinacidil in both solutions. Methods: Thirty-two rabbit hearts received 1 of 4 solutions in a crystalloid-perfused Langendorff apparatus: (1) UW, (2) WashU containing 0.5 mmol/liter pinacidil, (3) UW with 0.5 mmol/liter pinacidil, or (4) WashU without pinacidil. Thirty minutes of perfusion was followed by data acquisition consisting of left ventricular pressure-volume curves generated by inflating an intraventricular balloon. All hearts were placed in cold storage for 8 hours, followed by 1 hour of reperfusion before data acquisition. Results: Post-ischemic developed pressure (DP) was better preserved by WashU (76.8% ± 3.8%) than by UW (48.3% ± 2.5%). Diastolic compliance was better preserved by WashU (239.9% ± 77.2%) compared with UW (711.1% ± 193.1%). Removing pinacidil from our solution resulted in decreased DP (46.6% ± 3.2%) and diastolic compliance (688.8% ± 158.2%) Adding pinacidil to UW had a limited effect on DP and compliance. Conclusions: Our results support the superiority of the WashU hyperpolarizing solution for heart preservation over UW. Pinacidil was beneficial in maintaining cardiac function and compliance. This benefit was not observed when pinacidil was placed into the UW depolarizing solution.

AB - Background: The University of Wisconsin (UW) solution is the gold standard for heart preservation but has limitations in terms of both duration and adequacy of protection. Our laboratory has been interested in a more physiologic approach to heart preservation by maintaining the heart at its resting membrane potential (hyperpolarized arrest) with the KATP channel agonist pinacidil. This study compared our extracellular solution (WashU) with the UW intracellular depolarizing solution and quantified the protective effect of pinacidil in both solutions. Methods: Thirty-two rabbit hearts received 1 of 4 solutions in a crystalloid-perfused Langendorff apparatus: (1) UW, (2) WashU containing 0.5 mmol/liter pinacidil, (3) UW with 0.5 mmol/liter pinacidil, or (4) WashU without pinacidil. Thirty minutes of perfusion was followed by data acquisition consisting of left ventricular pressure-volume curves generated by inflating an intraventricular balloon. All hearts were placed in cold storage for 8 hours, followed by 1 hour of reperfusion before data acquisition. Results: Post-ischemic developed pressure (DP) was better preserved by WashU (76.8% ± 3.8%) than by UW (48.3% ± 2.5%). Diastolic compliance was better preserved by WashU (239.9% ± 77.2%) compared with UW (711.1% ± 193.1%). Removing pinacidil from our solution resulted in decreased DP (46.6% ± 3.2%) and diastolic compliance (688.8% ± 158.2%) Adding pinacidil to UW had a limited effect on DP and compliance. Conclusions: Our results support the superiority of the WashU hyperpolarizing solution for heart preservation over UW. Pinacidil was beneficial in maintaining cardiac function and compliance. This benefit was not observed when pinacidil was placed into the UW depolarizing solution.

UR - http://www.scopus.com/inward/record.url?scp=24344456019&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=24344456019&partnerID=8YFLogxK

U2 - 10.1016/j.healun.2004.10.011

DO - 10.1016/j.healun.2004.10.011

M3 - Article

C2 - 16143258

AN - SCOPUS:24344456019

VL - 24

SP - 1362

EP - 1368

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 9

ER -