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Research article
Binfeng Lei
Guangxi Medical University First Affiliated Hospital
Corresponding Author
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Background Congenital heart disease is one of the leading causes of death in newborns and infants. The development of fetal cardiac surgery is inextricably linked to extracorporeal circulation. We aimed to compare the effects of heart-stopping solutions and extracorporeal circulation on fetal sheep myocardium.
Methods Eighteen pregnant sheep were divided into the non-stop group, St. Thomas stopping solution group, and histidine–tryptophan–ketoglutarate stopping solution group. The three groups underwent the extracorporeal circulation. The right atrial myocardial tissue was removed from the fetal sheep at specific time points, and apoptosis was detected by TUNEL staining. Creatine kinase‒muscle band (CKMB), troponin I (cTnI), and troponin T (cTnT) were measured as indicators of myocardial damage.
Results There were no significant differences in the serum cTnT, cTnI, and CKMB concentrations of fetal sheep among the three groups before starting extracorporeal circulation (P = 0.430, P = 0.391, P = 0.071). Changes in the serum cTnI (ng/L) concentrations were not significantly different among the three groups before and during the extracorporeal circulation (P > 0.05). The cTnI in the St. Thomas solution group at 1 hour post extracorporeal circulation was significantly higher than prior to it (P < 0.05), and cTnI in the non-stop group and histidine–tryptophan–ketoglutarate group after 2 hours was higher than in the pre-bypass value (P < 0.05). The cTnI in the histidine–tryptophan–ketoglutarate group at 1 and 2 hours after the extracorporeal circulation was lower than in the St. Thomas solution group. The number of TUNEL-positive cells in the two solution groups was higher than in the non-stop group (P = 0.001 and P = 0.048, respectively). The number of TUNEL-positive cells in the St. Thomas solution group was higher than in the histidine–tryptophan–ketoglutarate group (P = 0.007).
Conclusion Myocardial protection in fetal sheep undergoing extracorporeal circulation was significantly better with non-stop beating than when the beating was stopped. Compared to the St. Thomas arrest solution, histidine‒tryptophan‒ketoglutarate stopping solution was associated with significantly reduced markers of myocardial damage in fetal sheep. Less cardiomyocyte apoptosis was observed when the beating was not stopped.
Keywords
Apoptosis, congenital heart disease, creatine kinase‒muscle band, extracorporeal circulation, fetal sheep, histidine‒tryptophan‒ketoglutarate solution, St. Thomas stopping solution, troponin.
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CURRENT STATUS: Published
View the published article at Journal of Cardiothoracic Surgery.
Version 1
Posted 30 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 09 Mar, 2021
Review #1 received
Received 02 Jan, 2021
Reviewer #3 agreed
On 26 Dec, 2020
Review #3 received
Received 26 Dec, 2020
Review #2 received
Received 26 Dec, 2020
Reviewer #2 agreed
On 25 Dec, 2020
Reviewers invited
Invitations sent on 22 Dec, 2020
Reviewer #1 agreed
On 22 Dec, 2020
Editor assigned
On 19 Dec, 2020
Submission checks complete
On 19 Dec, 2020
Editor invited
On 19 Dec, 2020
First submitted
On 16 Dec, 2020
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HTML Views: ...
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See the published version of this preprint at Journal of Cardiothoracic Surgery.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Binfeng Lei
Guangxi Medical University First Affiliated Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Journal of Cardiothoracic Surgery.
Version 1
Posted 30 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 09 Mar, 2021
Review #1 received
Received 02 Jan, 2021
Reviewer #3 agreed
On 26 Dec, 2020
Review #3 received
Received 26 Dec, 2020
Review #2 received
Received 26 Dec, 2020
Reviewer #2 agreed
On 25 Dec, 2020
Reviewers invited
Invitations sent on 22 Dec, 2020
Reviewer #1 agreed
On 22 Dec, 2020
Editor assigned
On 19 Dec, 2020
Submission checks complete
On 19 Dec, 2020
Editor invited
On 19 Dec, 2020
First submitted
On 16 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Journal of Cardiothoracic Surgery.
Background Congenital heart disease is one of the leading causes of death in newborns and infants. The development of fetal cardiac surgery is inextricably linked to extracorporeal circulation. We aimed to compare the effects of heart-stopping solutions and extracorporeal circulation on fetal sheep myocardium.
Methods Eighteen pregnant sheep were divided into the non-stop group, St. Thomas stopping solution group, and histidine–tryptophan–ketoglutarate stopping solution group. The three groups underwent the extracorporeal circulation. The right atrial myocardial tissue was removed from the fetal sheep at specific time points, and apoptosis was detected by TUNEL staining. Creatine kinase‒muscle band (CKMB), troponin I (cTnI), and troponin T (cTnT) were measured as indicators of myocardial damage.
Results There were no significant differences in the serum cTnT, cTnI, and CKMB concentrations of fetal sheep among the three groups before starting extracorporeal circulation (P = 0.430, P = 0.391, P = 0.071). Changes in the serum cTnI (ng/L) concentrations were not significantly different among the three groups before and during the extracorporeal circulation (P > 0.05). The cTnI in the St. Thomas solution group at 1 hour post extracorporeal circulation was significantly higher than prior to it (P < 0.05), and cTnI in the non-stop group and histidine–tryptophan–ketoglutarate group after 2 hours was higher than in the pre-bypass value (P < 0.05). The cTnI in the histidine–tryptophan–ketoglutarate group at 1 and 2 hours after the extracorporeal circulation was lower than in the St. Thomas solution group. The number of TUNEL-positive cells in the two solution groups was higher than in the non-stop group (P = 0.001 and P = 0.048, respectively). The number of TUNEL-positive cells in the St. Thomas solution group was higher than in the histidine–tryptophan–ketoglutarate group (P = 0.007).
Conclusion Myocardial protection in fetal sheep undergoing extracorporeal circulation was significantly better with non-stop beating than when the beating was stopped. Compared to the St. Thomas arrest solution, histidine‒tryptophan‒ketoglutarate stopping solution was associated with significantly reduced markers of myocardial damage in fetal sheep. Less cardiomyocyte apoptosis was observed when the beating was not stopped.
Figure 1
Figure 2
Figure 3
Figure 4
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