TY - JOUR
T1 - Electrophysiological Markers of Ex-Situ Heart Performance in a Porcine Model of Cardiac Donation After Circulatory Death
AU - Amesz, Jorik H.
AU - Bierhuizen, Mark F.A.
AU - Langmuur, Sanne J.J.
AU - Knops, Paul
AU - van Steenis, Yvar P.
AU - Dumay, Dwight
AU - van Schie, Mathijs S.
AU - Manintveld, Olivier C.
AU - de Groot, Natasja M.S.
AU - Taverne, Yannick J.H.J.
N1 - Publisher Copyright:
Copyright © 2024 Amesz, Bierhuizen, Langmuur, Knops, van Steenis, Dumay, van Schie, Manintveld, de Groot and Taverne.
PY - 2024
Y1 - 2024
N2 - Normothermic ex-situ heart perfusion (ESHP) enables assessment of hearts donated after circulatory death (DCD) prior to transplantation. However, sensitive parameters of cardiac function of DCD hearts on ESHP are needed. This study proposes a novel approach using electrophysiological (EP) parameters derived from electrical mapping as biomarkers of post-ischemic cardiac performance. Porcine slaughterhouse hearts (PSH) were divided in two groups based on the type of warm ischemia (Group 1: 10 ± 1 min with animal depilation vs. Group 2: ≤5 min without depilation). Electrical mapping of the right (RV) and left ventricle (LV) was performed on ESHP. Potential voltages, slopes and conduction velocities were computed from unipolar electrograms and compared between groups. Voltages were lower in Group 1 compared to Group 2 (RV: 3.6 vs. 15.3 mV, p = 0.057; LV: 10.8 vs. 23.6 mV, p = 0.029). In addition, the percentage of low-voltage potentials was higher and potential slopes were flatter in Group 1. Voltages and slopes strongly correlated with the visual contractile performance of PSH, but showed weaker correlation with lactate profiles. In conclusion, unipolar potential voltages and potential slopes were decreased in hearts with severe warm ischemia. As such, EP parameters could aid transplantation teams in decision-making on transplantability of DCD hearts.
AB - Normothermic ex-situ heart perfusion (ESHP) enables assessment of hearts donated after circulatory death (DCD) prior to transplantation. However, sensitive parameters of cardiac function of DCD hearts on ESHP are needed. This study proposes a novel approach using electrophysiological (EP) parameters derived from electrical mapping as biomarkers of post-ischemic cardiac performance. Porcine slaughterhouse hearts (PSH) were divided in two groups based on the type of warm ischemia (Group 1: 10 ± 1 min with animal depilation vs. Group 2: ≤5 min without depilation). Electrical mapping of the right (RV) and left ventricle (LV) was performed on ESHP. Potential voltages, slopes and conduction velocities were computed from unipolar electrograms and compared between groups. Voltages were lower in Group 1 compared to Group 2 (RV: 3.6 vs. 15.3 mV, p = 0.057; LV: 10.8 vs. 23.6 mV, p = 0.029). In addition, the percentage of low-voltage potentials was higher and potential slopes were flatter in Group 1. Voltages and slopes strongly correlated with the visual contractile performance of PSH, but showed weaker correlation with lactate profiles. In conclusion, unipolar potential voltages and potential slopes were decreased in hearts with severe warm ischemia. As such, EP parameters could aid transplantation teams in decision-making on transplantability of DCD hearts.
UR - http://www.scopus.com/inward/record.url?scp=85211584283&partnerID=8YFLogxK
U2 - 10.3389/ti.2024.13279
DO - 10.3389/ti.2024.13279
M3 - Article
C2 - 39635569
AN - SCOPUS:85211584283
SN - 0934-0874
VL - 37
JO - Transplant International
JF - Transplant International
M1 - 13279
ER -