2,3-Butanedione monoxime cardioplegia: advantages over hyperkalemia in blood-perfused isolated hearts

Ann Thorac Surg. 1999 Mar;67(3):618-23. doi: 10.1016/s0003-4975(98)01273-9.

Abstract

Background: 2,3-Butanedione monoxime (BDM) has been shown to possess cardioprotective properties related to the inhibition of cross-bridge force development, the reduction of myofilament Ca2+ sensitivity, and the attenuation of intracellular Ca2+ transients. This study tested the hypothesis that cardiac arrest achieved with BDM would be as effective as that achieved with St. Thomas' solution (StT).

Methods: Isolated rabbit hearts, studied on a blood-perfused Langendorff column, underwent 1 hour of ischemia (37 degrees C) and 30 minutes of reperfusion. Cardioplegia was administered every 20 minutes in the form of (1) Krebs-Henseleit solution only (control), (2) 20 mmol/L of BDM, or (3) StT. Recovery of developed pressure, atrioventricular activation times, and tissue water content were measured.

Results: Recovery of developed pressure for the control, BDM, and StT groups was 44%+/-3% (p<0.05 versus BDM and StT), 57%+/-5%, and 62%+/-4%, respectively. Atrioventricular activation times were significantly prolonged in the control group (42+/-15 ms, p = 0.042) and the StT group (26+/-9 ms, p = 0.034), but not in the BDM group (14+/-8 ms). Tissue water content after reperfusion was 80%+/-0.4%, 80%+/-0.2%, and 76%+/-1.0% (p<0.05 versus control) in the control, StT, and BDM groups, respectively.

Conclusions: 2,3-Butanedione monoxime was as effective as StT in protecting the myocardium. Unlike StT, BDM ameliorated myocardial edema and atrioventricular conduction delay after reperfusion.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Bicarbonates
  • Calcium Chloride
  • Cardioplegic Solutions*
  • Coronary Circulation
  • Diacetyl / analogs & derivatives*
  • Glucose
  • Heart / physiopathology
  • Heart Arrest, Induced
  • In Vitro Techniques
  • Magnesium
  • Myocardial Reperfusion
  • Myocardium / metabolism
  • Potassium / blood
  • Potassium Chloride
  • Rabbits
  • Sodium Chloride
  • Tromethamine

Substances

  • Bicarbonates
  • Cardioplegic Solutions
  • Krebs-Henseleit solution
  • St. Thomas' Hospital cardioplegic solution
  • Tromethamine
  • diacetylmonoxime
  • Sodium Chloride
  • Potassium Chloride
  • Magnesium
  • Glucose
  • Diacetyl
  • Calcium Chloride
  • Potassium