Custodiol HTK Versus Plegisol: in-Vitro Comparison With The Use of Immature (H9C2) and Mature (HCM) Cardiomyocytes Cultures
Abstract Background: Although cardioplegia is used since the ‘70s of the last century, debate on cardioprotection during cardio-surgical procedures is still actual. The selection of a particular method depends mainly on the preferences and experience of a specific center or even surgeon. Crystalloid cardioplegia is an aqueous ion solution similar to intracellular (Custodiol HTK) or extracellular (Plegisol) fluid. Numerous publications compare different types of cardioplegic solutions, but only a few used cultured cells in laboratory conditions. Methods: In this study, the authors compare two crystalloid solutions using an in-vitro model simulating cardioplegic arrest. The efficacy of myocardial protection during ischemia was investigated with susceptible indicators like the appearance of the deleterious effect of reactive oxygen species and oxidative stress markers. Incubated human cardiomyocytes and rat cardiomyoblasts H9C2 in cardioplegia for 4h were examined for expression of oxidative stress markers (MnSOD, iNOS, HSP27), cardioplegic solutions cytotoxicity, and peroxidation damage of the cell’s lipids and proteins. All tests were performed after 0.5h, 1h, 2h, and 4h in identical physical and biological conditions, which is difficult to achieve in clinical trials. Results: The tests performed on matured cells of human cardiomyocytes showed the superiority of Custodiol HTK. Differences between solutions on immature cells H9C2 were not relevant. Both Plegisol and Custodiol HTK produced a similar expression of MnSOD and iNOS. There was no significant advantage of Custodiol over Plegisol in the cytotoxicity test. However, Custodiol induced a higher level of lipid peroxidation. Conclusions: Considering proceeded examinations on cultured cardiomyocytes, Custodiol HTK appears to be safer than Plegisol.