Objectives Clinical studies indicate encouraging cardioprotective potential for Cardioplexol. Its cardioprotective capacities during 45 minutes of ischemia compared with pure no-flow ischemia or during 90 minutes of ischemia compared with Calafiore cardioplegia were investigated experimentally.

Methods Forty-four rat hearts were isolated and inserted into a blood-perfused pressure-controlled Langendorff apparatus. In a first step, cardiac arrest was induced by Cardioplexol or pure no-flow ischemia lasting 45 minutes. In a second step, cardiac arrest was induced by Cardioplexol or Calafiore cardioplegia lasting 90 minutes. For both experimental steps, cardiac function, metabolic parameters, and troponin I levels were evaluated during 90 minutes of reperfusion. At the end of reperfusion, hearts were fixed, and ultrastructural integrity was examined by electron microscopy.

Results Step 1: after 90 minutes of reperfusion, hearts exposed to Cardioplexol had significantly higher left ventricular developed pressure (CP-45ˊ: 74%BL vs. no-flow-45ˊ: 45%BL; p = 0.046) and significantly better maximal left ventricular relaxation (CP-45ˊ: 84%BL vs. no-flow-45ˊ: 51%BL; p = 0.012). Oxygen consumption, lactate production, and troponin levels were similar in both groups. Step 2: left ventricular developed pressure was lower (22 vs. 48% of BL; p = 0.001) and coronary flow was lower (24 vs. 53% of BL; p = 0.002) when Cardioplexol was used compared with Calafiore cardioplegia. Troponin I levels were significantly higher under Cardioplexol (358.9 vs. 106.1 ng/mL; p = 0.016).

Conclusion Cardioplexol significantly improves functional recovery after 45 minutes of ischemia compared with pure ischemia. However, Cardioplexol protects the myocardium from ischemia/reperfusion-related damage after 90 minutes of ischemia worse than Calafiore cardioplegia.

目的 临床研究表明 Cardioplexol 具有令人鼓舞的心脏保护潜力。通过实验研究了其在 45 分钟缺血期间与纯无血流缺血期间或在 90 分钟缺血期间与 Calafiore 心脏停搏液相比的心脏保护能力。

方法 分离 44 只大鼠心脏，并将其插入血液灌注的压力控制 Langendorff 装置中。第一步，通过 Cardioplexol 或持续 45 分钟的纯无血流缺血诱导心脏骤停。第二步，用 Cardioplexol 或 Calafiore 心脏停搏液诱导心脏骤停，持续 90 分钟。对于这两个实验步骤，在再灌注 90 分钟期间评估了心脏功能、代谢参数和肌钙蛋白 I 水平。再灌注结束时，固定心脏，并通过电子显微镜检查超微结构的完整性。

结果 第 1 步：再灌注 90 分钟后，接受 Cardioplexol 的心脏左心室展开压显着升高（CP-45ˊ：74%BL 对比 no-flow-45ˊ：45%BL；p = 0.046），最大左心室显着 改善心室舒张（CP-45ˊ：84%BL vs. no-flow-45ˊ：51%BL；p  = 0.012）。两组的耗氧量、乳酸产量和肌钙蛋白水平相似。 步骤 2：与 Calafiore 心脏停搏液相比，使用 Cardioplexol 时，左心室发展压较低（22% vs. BL 的 48%；p  = 0.001），冠脉流量较低（24% vs. BL 的 53%；p = 0.002）。使用 Cardioplexol 后，肌钙蛋白 I 水平显着升高（358.9 与 106.1 ng/mL；p  = 0.016）。

结论 与单纯缺血相比，Cardioplexol 显着改善缺血 45 分钟后的功能恢复。然而，Cardioplexol 在缺血 90 分钟后保护心肌免受缺血/再灌注相关损伤的效果比 Calafiore 心脏停搏液更严重。