Key result
Histidine-tryptophan-glutamate cardioplegia reduces myocardial apoptosis and boosts cell proliferation compared to HTK.
Why the study?
Does histidine-tryptophan-glutamate solution improve myocardial preservation compared to histidine-tryptophan-ketoglutarate in isolated rat hearts?
Does histidine-tryptophan-glutamate solution improve myocardial preservation compared to histidine-tryptophan-ketoglutarate in isolated rat hearts?
Replacing alpha-ketoglutarate with glutamate in cardioplegic solutions may offer better myocardial preservation by reducing apoptosis and enhancing early proliferative activity in preclinical models.
Answers are grounded in this paper and cite their sources.
May reduce apoptosis in rat hearts; leaves open clinical translation of glutamate-based cardioplegia.
INTRODUCTION: Cardiac arrest during heart surgery is a common procedure and allows the surgeon to perform surgical procedures in an environment free of blood and movement. Using a model of isolated rat heart, the authors compare a new cardioplegic solution containing histidine-tryptophan-glutamate (group 2) with the histidine-tryptophan-alphacetoglutarate (group 1) routinely used by some cardiac surgeons. OBJECTIVE: To assess caspase, IL-8 and KI-67 in isolated rat hearts using immunohistochemistry. METHODS: 20 Wistar male rats were anesthetized and heparinized. The chest was opened, cardioctomy was performed and 40 ml/kg of the appropriate cardioplegic solution was infused. The hearts were kept for 2 hours at 4ºC in the same solution, and thereafter, placed in the Langendorff apparatus for 30 minutes with Ringer-Locke solution. Immunohistochemistry analysis of caspase, IL-8, and KI-67 were performed. RESULTS: The concentration of caspase was lower in group 2 and Ki-67 was higher in group 2, both P<0.05. There was no statistical difference between the values of IL-8 between the groups. CONCLUSION: Histidine-tryptophan-glutamate solution was better than histidine-tryptophan-alphacetoglutarate solution because it reduced caspase (apoptosis), increased KI-67 (cell proliferation), and showed no difference in IL-8 levels compared to group 1. This suggests that the histidine-tryptophan-glutamate solution was more efficient than the histidine-tryptophan-alphacetoglutarate for the preservation of hearts of rat cardiomyocytes.
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Oliveira et al. (2014) studied Myocardial ischemia-reperfusion injury / cardioplegia model (n=20). Histidine-tryptophan-glutamate (HTG) solution vs. Histidine-tryptophan-ketoglutarate (HTK) solution was evaluated on Caspase, IL-8, and KI-67 activity in myocardial cells (p=<0.0001). The histidine-tryptophan-glutamate solution significantly reduced caspase activity (apoptosis) and increased KI-67 activity (cell proliferation) compared to the histidine-tryptophan-ketoglutarate solution (P<0.0001 for both).
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