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Comparative Effects of Continuous Warm Blood and Intermittent Cold Blood Cardioplegia on Coronary Reactivity  Motohisa Tofukuji, MD, PhD, Alon Stamler,

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Presentation on theme: "Comparative Effects of Continuous Warm Blood and Intermittent Cold Blood Cardioplegia on Coronary Reactivity  Motohisa Tofukuji, MD, PhD, Alon Stamler,"— Presentation transcript:

1 Comparative Effects of Continuous Warm Blood and Intermittent Cold Blood Cardioplegia on Coronary Reactivity  Motohisa Tofukuji, MD, PhD, Alon Stamler, MD, Jianyi Li, MB, MS, Mukesh D. Hariawala, MD, Alvin Franklin, MS, Frank W. Sellke, MD  The Annals of Thoracic Surgery  Volume 64, Issue 5, Pages (November 1997) DOI: /S (97) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 In vitro responses of precontracted porcine coronary microvessels to isoproterenol from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of relaxation of the acetylcholine-induced vascular contraction. (**p<0.01 versus control group.) The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 In vitro responses of precontracted porcine coronary microvessels to forskolin from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of the relaxation of the acetylcholine-induced vascular contraction. (*p<0.05 versus iCB-CP; **p<0.01 versus control and cWB-CP groups.) The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 In vitro responses of precontracted porcine coronary microvessels to 8-bromo-cyclic adenosine monophosphate (AMP) from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of the relaxation of the acetylcholine-induced vascular contraction. (*p<0.05 versus iCB-CP-Rep group.) The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 In vitro responses of precontracted porcine coronary microvessels to adenosine 5′-diphosphate (ADP) from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of the relaxation of the acetylcholine-induced vascular contraction. The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 In vitro responses of precontracted porcine coronary microvessels to the calcium ionophore A23187 from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of the relaxation of the acetylcholine-induced vascular contraction. The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 In vitro responses of precontracted porcine coronary microvessels to 8-bromo-cyclic guanosine monophosphate (GMP) from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of the relaxation of the acetylcholine-induced vascular contraction. (*p<0.05 versus control and cWB-CP groups; #p<0.05 versus cWB-CP-Rep group.) The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

8 Fig 7 In vitro responses of precontracted porcine coronary microvessels to sodium nitroprusside (SNP) from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of the relaxation of the acetylcholine-induced vascular contraction. The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

9 Fig 8 In vitro responses of precontracted porcine coronary microvessels to pinacidil from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Responses are expressed as the percentage of the relaxation of the acetylcholine-induced vascular contraction. The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

10 Fig 9 Plot showing (A) active and (B) passive pressure–diameter relationships in porcine coronary microvessels from control hearts, hearts after 1 hour of ischemic cardioplegic arrest using intermittent cold blood (iCB-CP) or continuous warm blood (cWB-CP) cardioplegic solution, or after ischemic arrest with either cardioplegia, followed by 1 hour of reperfusion (iCB-CP-Rep or cWB-CP-Rep). Passive pressure– diameter relationships were obtained after pretreatment of the vessels with 0.1mmol/L papaverine (Pap). Vessel diameters were normalized to diameters at a pressure of 50mm Hg after the application of 0.1mmol/L papaverine. (**p<0.01 control versus iCB-CP, iCB-CP-Rep, cWB-CP, and cWB-CP-Rep groups.) The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

11 Fig 10 Plot showing (A) heart rate (HR), (B) mean systemic arterial pressure (MAP) and (C) blood flow of left anterior descending artery (LAD flow) at baseline and at 10, 20, 30, and 60 minutes after reperfusion using intermittent cold blood or continuous warm blood cardioplegic solution (iCB-CP-Rep or cWB-CP-Rep). (*p<0.05 versus iCB-CP-Rep group.) The Annals of Thoracic Surgery  , DOI: ( /S (97) ) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

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