Fructose-1,6-diphosphate and a glucose-free solution enhances functional recovery in hypothermic heart preservation
Fructose-1,6-diphosphate and a glucose-free solution enhances functional recovery in hypothermic heart preservation
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DOI：
10.1016/s1053-2498(99)00142-4
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发表时间：
2000-03-01
影响因子：
8.9
通讯作者：
Gray, LA
中科院分区：
文献类型：
--
作者：
Chien, S;Zhang, FT;Gray, LA
背景：1，6-二磷酸果糖(FDP)已被证明在各种缺血条件下对组织的缺氧有保护作用，包括隔离心脏灌流。我们验证了在St.Thomas液中加入FDP可以延长低温心脏保存时间的假设。方法：选用16只成年SD大鼠。在全身麻醉下，取出心脏，在4℃的St.Thomas液(30ml/kg)中保存12h。研究组(n=8)在St.Thomas液中加入5 mM的FDP，对照组(n=10)不使用FDP。结果：实验组心输出量为13.00±2.34~17.66±1.71ml/m in，最大主动脉流量为3.4±/-1.99~9.26±1.72m l/m in，每搏输出量为0.074±/-0.014~0.092+/-0.009 m l，每搏功为6.22±/-0.39~7.95+/-0.44 m l/mm Hg。最大左心室产生功率为14.38±2.94~20.16±2.49焦耳/分钟。上述各项指标均高于对照组(P<；0.001)。冠脉阻力和心肌组织湿/干重比值研究组低于对照组(p<；0.05)。结论：St.Thomas液中加入FDP能更好地保护心脏低温保存过程中的心功能。其机制尚不完全清楚，但在缺血期间增强高能磷酸盐的产生是可能的。
Background: Fructose-1,6-diphosphate (FDP) has been shown to protect tissue during hypoxia under various ischemic conditions, including isolated heart perfusion. We tested the hypothesis that adding FDP to St. Thomas solution can extend hypothermic heart preservation time.Methods: Sixteen adult Sprague-Dawley rats were used. Under general anesthesia, the hearts were removed and preserved at 4 degrees C in St. Thomas solution (30 ml/kg) for 12 hours. FDP (5 mM) was added to the St. Thomas solution in the study group (n = 8), whereas no FDP was used in the control group (n = 10). The hearts were reperfused after 12 hours of preservation using a working heart model.Results: In the study group, cardiac output ranged from 13.00 +/- 2.34 to 17.66 +/- 1.71 ml/min, maximum aortic flow was 3.40 +/- 1.99 to 9.26 +/- 1.72 ml/min, left ventricular stroke volume ranged from 0.074 +/- 0.014 to 0.092 +/- 0.009 ml, left ventricular stroke work ranged from 6.22 +/- 0.39 to 7.95 +/- 0.44 ml/mmHg, and maximum left ventricular generated power was 14.38 +/- 2.94 to 20.16 +/- 2.49 Joules/min. All of these parameters were higher than those in the control group (p < 0.001). Coronary vascular resistance and myocardial tissue wet/dry weight ratio were lower in the study group than in the control group (p < 0.05).Conclusions: Heart function was better preserved when FDP was added to St. Thomas solution during hypothermic rat heart preservation. The mechanism is not totally clear, but enhancement of high-energy phosphate production during ischemia is possible.