Korean Circ J.  2016 May;46(3):402-407. 10.4070/kcj.2016.46.3.402.

Levosimendan Reduces Lung Injury in a Canine Model of Cardiopulmonary Bypass

Affiliations
  • 1The First Ward of Cardiovascular Surgery Department of the First Affiliated Hospital of Anhui Medical University, Hefei, China. aydgsl@sina.com
  • 2The Oncology Department of the Hefei Second People's Hospital, Hefei, China.

Abstract

BACKGROUND AND OBJECTIVES
To explore the lung-protective effect of levosimendan (LS) during cardiopulmonary bypass in a canine model by determining the wet/dry weight (W/D) ratio of lung tissue, malonaldehyde (MDA) and superoxide dismutase (SOD) concentrations, and performing a histological evaluation.
MATERIALS AND METHODS
Thirty-two canines were divided randomly into four groups and underwent a routine aortic cross-clamping cardiopulmonary bypass procedure for 1 h, followed by recovery for 2 h. Animals were handled as follows: group C (means control group), no special treatment after aortic cross clamping; group P (means pulmonary artery perfusion group), pulmonary artery perfusion with cold oxygenated blood after aortic cross clamping; group LSIV (means intravenous injection of LS group), intravenous injection of LS (65 µg/kg) before thoracotomy, and the rest of the procedure was identical to the control group; group LPS (means pulmonary perfusion with LS group), pulmonary perfusion with cold oxygenated blood combined with LS (65 µg/kg) after aortic cross clamping. Lung tissues were removed and subjected to evaluation of pathological alterations, W/D ratio and MDA and SOD concentrations.
RESULTS
In group C, the W/D ratio and MDA concentration were higher, while the SOD concentrations were lower (p<0.05). Compared with groups P and LSIV, the MDA concentration was lower in group LPS, while that of SOD was higher (p<0.05); Light and electron microscopy indicated that LS intervention reduced impairment of lung tissues.
CONCLUSION
Our findings suggest that LS plays an important role in protecting lung tissues.

Keyword

Levosimendan; Cardiopulmonary bypass; Canine; protective effect

MeSH Terms

Animals
Cardiopulmonary Bypass*
Constriction
Injections, Intravenous
Lung Injury*
Lung*
Malondialdehyde
Microscopy, Electron
Oxygen
Perfusion
Pulmonary Artery
Superoxide Dismutase
Thoracotomy
Malondialdehyde
Oxygen
Superoxide Dismutase

Figure

  • Fig. 1 Column charts for each data. (A) W/D ratio of lung tissue. the mean W/D ratio was higher in group C than in the other three groups. (B) MDA concentration. The MDA concentration was highest in group C and lowest in group LSP. (C) SOD concentration. The SOD concentration was lowest in group C and highest in group LSP. W/D: wet/dry weight, MDA: malonaldehyde, SOD: superoxide dismutase, C: control group, LSP: pulmonary perfusion with LS group.

  • Fig. 2 Light micrograph of lung tissues (HE staining of lung tissues, ×100). (A) group LSP, (B) group C, (C) group P, and (D) group LSIV. As shown in Fig. 1, edema of intercellular fluid, infiltration of inflammatory cells and destroyed alveolar space containing massive numbers of erythrocytes and inflammatory cells and large amounts of serous exudate were found in groups C and LSIV. Compared with group C, edema, inflammatory infiltration, hemorrhage and exudate in groups P and LSP were significantly ameliorated. LSP: pulmonary perfusion with LS group, C: control group, P: pulmonary artery perfusion group, LSIV: intravenous injection of LS group.

  • Fig. 3 Electron micrographs of lung tissues (electron microscopy observation of type II epithelial cells, ×20000). (A) group LSP, (B) group C, (C) group P, and (D) group LSIV. As shown in Fig. 2, mitochondria of II type epithelial cells were swollen and the electron density of the mitochondrial matrix was decreased in groups C, LSIV and LSP. Structures exhibited chaotic ridges, vacuolization of lamellar bodies, fewer microvilli in the cell membrane and nuclear pleomorphism. However, these alterations were significantly ameliorated in groups LSP and P. LSP: pulmonary perfusion with LS group, C: control group, P: pulmonary artery perfusion group, LSIV: intravenous injection of LS group.


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