Myocardial protective effect of donor heart preservation perfusate containing Xuebijing injection on isolated beating pig heart preserved by ECMO
Objective To observe the myocardial protective effect of donor heart preservation perfusate containing Xuebijing injection on the isolated beating pig heart preserved by extracorporeal membrane oxygenation(ECMO),and to explore its possible mechanism.Methods Twelve healthy adult Guangxi Bama miniature pigs were randomly divided in-to the control group and Xuebijing group,with 6 pigs in each group.The ECMO-preserved beating heart models were estab-lished in the control group and Xuebijing group.The models were continuously perfused with leukocyte-depleted oxygenat-ed blood containing 50 mL Xuebijing injection and normal saline,respectively,to maintain the beating heart for 8 h.Heart rate,perfusion pressure and perfusion flow were recorded at 0(T1),2(T2),4(T3),6(T4)and 8 h(T5)after perfusion.The levels of interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by ELISA.The myocardial injury markers troponin I(cTnI),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)and lactate dehydrogenase(LDH)were detected by automatic biochemical analyzer after heparinization and before perfu-sion(T0)and at T1-T5 time points.The ultrastructure of myocardial tissue in the two groups at T5 was observed under transmission electron microscope.Results There were no significant differences in heart rate,perfusion pressure or per-fusion flow between the two groups at T1-T5(all P>0.05).The levels of serum IL-1β,IL-6,TNF-α and perfusion fluid cTnT,CK,CK-MB and LDH at T3-T5 in the control group increased,and the levels of perfusion fluid cTnT,CK,CK-MB and LDH at T4-T5 in Xuebijing group increased in comparison with those at T1 time point in the same group(all P<0.05).The levels of serum IL-1β,IL-6,TNF-α and cTnT in the Xuebijing group at T3-T5 were lower than those in the control group,and the levels of CK,CK-MB and LDH in the perfusion fluid at T2-T5 were lower than those in the control group(all P<0.05).Ultrastructure of myocardial tissue:In the control group,the ventricular muscle tissue showed moder-ate to severe degeneration and steatosis,the intracellular matrix was dissolved in a large area,the muscle fiber structure was disordered and broken in a large amount,the mitochondria were mostly swollen and uneven in size,and the cell mem-brane was dissolved and damaged.Compared with the control group,the cell structure damage in the Xuebijing group was relatively mild,the myocardial cells were slightly hypertrophic,the mitochondria were slightly swollen and uniform in size,and the muscle fibers were uniform in thickness and neatly arranged.Conclusions The addition of Xuebijing injec-tion to the donor heart preservation perfusate has the myocardial protective effect on the isolated beating pig heart preserved by ECMO,and its mechanism may be related to the inhibition of inflammatory response and the reduction of mitochondrial damage in cardiomyocytes.
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