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Eur J Cardiothorac Surg 2001;19:647-652
© 2001 Elsevier Science NL

Ultra-short-acting cardioselective beta-blockade attenuates postischemic cardiac dysfunction in the isolated rat heart

Department of Surgery (I), Kanazawa University School of Medicine, Takaramachi 13-1, Kanazawa 920-8641, Japan

Received 18 December 2000; received in revised form 16 February 2001; accepted 28 February 2001.

Corresponding author. Tel.: +81-76-265-2356; fax: +81-76-222-6833
e-mail: yasuda717{at}nyc.odn.ne.jp

Objectives: We sought to test the effectiveness of ultra-short-acting cardioselective beta-blockade, landiolol hydrochloride, for warm heart surgery. Methods: The isolated perfused rat heart preparation was used. After preischemic measurement of cardiac function, 3 min of coronary infusion of crystalloid cardioplegic solution (37°C) with landiolol hydrochloride of various concentrations (1, 2.5, 5, and 10 mmol/l) or without it (control group) was performed, followed by 30 min of warm ischemic arrest. Finally, postischemic function was measured. Results: The percentage recoveries of heart rate in hearts receiving 0, 1, 2.5, 5, and 10 mmol/l landiolol hydrochloride were 89.4±3.4%, 90.9±1.7%, 89.6±1.8%, 83.4±3.3%, and 74.3±1.9% (P<0.05 vs. 0, 1, and 2.5 mmol/l groups), respectively. The percentage recoveries of aortic flow were 55.6±3.1%, 62.8±3.3%, 75.0±4.2% (P<0.05 vs. 0 and 10 mmol/l groups), 65.3±5.3%, and 51.6±4.0%, respectively. Similar recovery profiles were observed with the first derivative of the rise in aortic pressure, stroke volume and stroke work. The total amount of coronary effluent in the hearts receiving 5 or 10 mmol/l was lower than in the other groups. Conclusions: Landiolol hydrochloride has the potential to enhance postischemic cardiac function after the warm cardioplegic arrest. The optimal concentration for maximum postischemic functional recovery was 2.5 mmol/l, and recoveries of aortic flow and heart rate decreased in hearts receiving 5 mmol/l or more.

Key Words: Beta-blockade • Myocardial protection • Warm heart surgery

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