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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 908-917, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
H Kawata, K Sawatari and JE Mayer Jr
The role of neutrophils in reperfusion injury after hypothermic,
cardioplegia-protected ischemia is incompletely understood but may involve
neutrophil-endothelial interactions. We examined 33 isolated blood-perfused
neonatal lamb hearts arrested for 2 hours with 15 degrees C potassium
cardioplegic solution and reperfused with unmodified blood (group C, n =
9), with neutrophil-depleted (Sepacell filter) blood (group ND, n = 9),
with the addition of CV-3988, a platelet-activating factor antagonist, to
the perfusate (group NA, n = 9), and with neutrophil-depleted blood plus
CV-3988 (group ND/NA, n = 6). The percent recovery of isovolumic left
ventricular developed pressure at a fixed balloon volume at 30 minutes
after reperfusion in groups ND (84.8% +/- 11.8%, mean +/- standard
deviation), NA (89.9% +/- 11.5%), and ND/NA (87.8% +/- 6.4%) were higher
than in group C (73.1% +/- 7.9%) (p less than 0.05). Groups NA (105.5% +/-
13.7%) and ND/NA (108.0% +/- 11.2%) achieved higher percent recovery of
coronary blood flow than group C (84.4% +/- 10.4%) (p less than 0.05). In
each heart, we also tested coronary vascular resistance response to
infusion of acetylcholine 10(-6) mol/L to assess endothelial function.
Percent recovery of coronary vascular resistance response to acetylcholine
was higher in groups ND (56.8% +/- 31.4%), NA (56.3% +/- 17.3%), and ND/NA
(58.7% +/- 24.8%) than in group C (13.3% +/- 38.3%) (p less than 0.05).
These results show that, after ischemia/reperfusion, groups ND, NA, and
ND/NA had better recovery of both mechanical and endothelial function than
group C. The parallel changes in recovery of mechanical and endothelial
function suggest that neutrophil-endothelial interactions may be a
significant factor in reperfusion injury.
ARTICLES
Evidence for the role of neutrophils in reperfusion injury after cold cardioplegic ischemia in neonatal lambs
Department of Cardiovascular Surgery, Children's Hospital, Boston, Mass. 02115.
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