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Singh et al. Myocardial protection in cardiac transplantation

Table 2: Comparison of studies comparing cardioplegic agents
Year of
Study Type Solution Cases (n) Findings Comment
study
Vega et al. [50] 2001 Open Label RCT Celsior vs. Celsior (64) Fewer patients in the Celsior Younger recipients in
(Humans) Standard of SOC (67) group experienced at least control group
care (UW, one cardiac-related serious
STh, others) adverse event
Wieselthaler et al. [51] 1999 Open Label RCT HTK vs. HTK (24) Increased Ischaemic time Similar outcomes
(Humans) Celsior Celsior (24) for HTK group (P-values not
given)
2 cases of Acute graft failure
in HTK cohort
Cannata et al. [52] 2012 Retrospective Celsior vs. HTK (61) Celsior Similar outcomes Similar outcomes
cohort (humans) HTK vs. STh (38) STh (34)
George et al. [53] 2012 Retrospective UW vs. Celsior UW (42) UW is associated with less
cohort Celsior (134) acute ischaemic necrosis
(on pathology) than CS
George et al. [54] 2011 Retrospective UW vs. Celsior UW (3,107) Celsior In high-risk allografts, UW recipient cohort
cohort (1,803) UW was associated with had significantly
improved survival better haemodynamic
readings pre-
operatively
Kofler et al. [55] 2009 Retrospective UW vs. HTK UW (118) HTK UW demonstrated a HTK group was
cohort (222) significantly better survival derived from historic
(humans) control
Garlicki et al. [56] 1999 Retrospective UW vs. Celsior UW (64) HTK had highest mortality Statistical significance
cohort vs. HTK CEL (28) uncertain as P-values
HTK (132) unavailable
Lee et al. [57] 2011 Prospective HTK vs. NA HTK = Significant reduction HTK- superior
cohort Celsior in serum troponin I & protective effects
creatine phosphokinase against ischemia-
Lewis donor rat HTK = reduction in reperfusion in older
upregulation of mRNA for donors
interleukin-6, intercellular
adhesion molecule-1, and
tumor necrosis factor-a,
fewer infiltrating cells,
less apoptosis, and less
phosphorylated adenosine
monophosphate-activated
protein kinase
Ackemann et al. [58] 2002 Prospective HTK vs. 19 (HTK) vs. 19 HTK = more ATP after 8 and HTK = better LV
cohort Celsior (Celsior) 12 h of ischemia function, less prone to
arrhythmic events
28 to 35 kg adult
fox hound dogs

NA: not applicable; LV: left ventricular; HTK: histidine-tryptophan-ketoglutarate

the upper limit of normal, while in recipients, it was prohibiting complementary messenger RNAs (mRNAs)
the levels were all markedly elevated with greater translation into functional proteins. Wang et al. [67]
heterogeneity. Posto-peratively, BNP had a moderate attempted to monitor initial injury to the myocardium
correlation with ischaemic time (ρ = 0.52, P = 0.01), and post-operative recovery by detecting levels of
donor BNP (ρ = 0.45, P = 0.03), and donor troponin-I circulating muscle-specific miRNAs in 7 consecutive
(ρ = 0.49, P = 0.01). The post-operative concentrations patients. Fourteen controls were also included in their
of BNP were significantly higher in patients requiring study. Samples were obtained at daily intervals post
increasing doses of inotropic support. However, there transplantation. They also collected cTnI levels. Their
was no correlation between post-operative troponin I results showed significant correlation between miRNAs
and the measured parameters. and cTnI (P < 0.05) and the circulating concentrations of
both proteins were strongly correlated with bypass time.
The role of microRNAs (miRNAs) as a biomarker Circulating miR-133b correlated well with parameters
for cardiac disease is rapidly expanding due to its of heart function such as central venous. It also had
rapid release kinetics, cardio-selectivity and plasma strong correlations with ventilation time (r > 0.99, P <
stability [66] . It negatively regulates gene expression by 0.001) and length of ICU stay (r > 0.92, P < 0.05). They

218 Vessel Plus ¦ Volume 1 ¦ December 28, 2017