Key Points
- This research aims to determine the impact of leukocytes on coronary endothelial injury associated with ischemia and reperfusion.
- The study used a canine model of myocardial ischemia and reperfusion with extracorporeal circulation.
- Canines underwent a 60-minute left anterior descending occlusion followed by 120 minutes of reperfusion with or without leukocyte filtering.
- Endothelial function was assessed in vitro using vasodilators and measuring microvascular permeability with radiolabeled compounds.
- In unfiltered dogs, the protein leak index of ischemic myocardium increased significantly (2.3-fold, p < 0.05) compared to nonischemic myocardium.
- No significant difference was found in protein leak index between ischemic and nonischemic myocardium in filtered dogs (1.5 +/- 0.4 vs. 1.9 +/- 0.5, p = NS).
- Endothelium-dependent vasodilation was impaired in coronary artery rings from affected dogs, but leukocyte filtering did not consistently improve relaxation.
Structured PICO
Does leukocyte removal by filtering prevent coronary endothelial injury in a canine model of myocardial ischemia and reperfusion?
PPopulationAnesthetized dogs subjected to a 60-minute left anterior descending occlusion followed by 120 minutes of reperfusion via an extracorporeal circulation (n=12)
IInterventionLeukocyte removal by filtering in the extracorporeal circuit during reperfusion
CComparatorReperfusion without leukocyte filters in the extracorporeal circuit
OOutcomeMicrovascular permeability (protein leak index) and endothelium-dependent dilation of epicardial coronary arteriessurrogate
Leukocytes mediate microvascular, but not epicardial, endothelial injury secondary to ischemia and reperfusion in the coronary circulation.