<Originals>Energy metabolism of long-term preserved rabbit and rat hearts : evaluation by 31-phosphorus nuclear magnetic resonance

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Heart transplantation has come to be increasingly important as a treatment for severe heart diseases. In more recent years, trial transplantations of preserved hearts have been carried out ; thus reliable heart preservation methods and viability evaluation have become necessary. This study aims to evaluate the viability of preserved hearts by the nuclear magnetic resonance (NMR) spectroscopy. The hearts were preserved mostly by simple immersion, some by continuous coronary perfusion. In isolated rat hearts, the myocardial viability was compared between the preservations with extracellular and intracellular fluids ; in the rabbit hearts, the viabilities were evaluated under simple immersion in modified Collins' solution at 4℃ for 12,24 and 36 hours. Further, changes in high-energy phosphate in the rabbit hearts preserved by continuous perfusion at 4℃ with modified Collins' solution (2 ml/kg/min) were observed. Myocardial viability was evaluated by NMR for determining adenosine triphosphate (ATP) and creatine phosphate (CrP) in the myocardium. The changes in such high-energy phosphates were expressed as percentages of the levels before cardiac arrest. As a result, intracellular fluid exhibited better myocardial viability than did extracellular fluid. After simple immersion for 36 and 24 hours, myocardial CrP on reperfusion reached only 37.0±15.1% and 67.1±29.7%, respectively ; peak myocardial ATP levels were 32.5±15.2% and 44.6±16.4%, suggesting an insufficient viability. After preservation for 12 hours, reperfusion showed CrP returning to control levels and ATP shifting at the levels exceeding 80% of control. These results suggest that simple immersion can satisfactorily preserve the heart for 12 hours. CrP and ATP in the heart preserved by continuous perfusion decreased slightly, staying at 73.0±28.5% and 82.6±10.1% three hours later, respectively, but caused myocardial edema, which suggested that continuous perfusion was not superior to simple immersion. NMR seems to be a good way to evaluate myocardial viability, because it is non-invasive and repeatable. This study suggests that the evaluation of the preserved heart by NMR may be applicable to clinical practice, provided that some parts of the apparatus are improved.
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<Originals>Energy metabolism of long-term preserved rabbit and rat hearts : evaluation by 31-phosphorus nuclear magnetic resonance

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