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Cardiology Division, Department of Pediatrics, University of Washington, Seattle 98195; and Children's Hospital and Regional Medical Center, Seattle, Washington 98105
Hypothermia improves resistance
to subsequent ischemia in the cardioplegic-arrested heart
(CAH). This adaptive process produces mRNA elevation for heat shock
protein (HSP) 70-1 and mitochondrial proteins,
adenine nucleotide translocator
(ANT1), and
-F1-ATPase. Glucose in
cardioplegia also enhances myocardial protection. These processes might
be linked to reduced ATP depletion. To assess for synergism between
these protective processes, isolated rabbit hearts
(n = 91) were perfused at 37°C and
exposed to ischemic cardioplegic arrest for 2 h. Hearts were in four
groups: control (C), hypothermia adapted (H) perfused to 31°C 20 min before ischemia, 22 mM glucose (G) in cardioplegia, and
hypothermic adaptation and glucose (HG). Developed pressure (DP),
dP/dtmax, and
pressure-rate product (PRP) improved
(P < 0.05) in G, H, and HG compared
with C during reperfusion. DP and PRP were elevated in HG over H and G. ATP was higher in G, H, and HG, although no additional increase in HG
over H was found. Lactate and CO2
production were elevated in G only. The mRNA expression for
HSP70-1, ANT1, and
-F1-ATPase was elevated
severalfold in H and HG, but not G over C during reperfusion. In
conclusion, glucose provides additional functional improvement in H. Additionally, neither ATP levels nor anaerobic metabolism are linked to
mRNA expression for HSP70, ANT1,
or
-F1-ATPase in CAH.
stress response; RNA; cardiac surgery
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