Coronary heart disease is a major cause of death and disability in most developed countries. Irreversible myocardial damage resulting from occlusion of the coronary arteries leads to heart failure syndrome, when the contractility of the heart muscle is inadequate to the metabolic needs of the body.
Myocardial revascularization is a radical method of treating patients with coronary heart disease and the most effective way to manage heart failure, in the case of a marked reduction in contractility the option is a donor heart transplantation.
More than 4,000 heart transplants are performed every year worldwide, mainly in Europe and North America. In recent years, the number of heart transplant procedures has been growing in Russia. However, a common problem for all countries is a shortage of available donor hearts as not all potential donors are suitable for heart donation. One of the limiting factors is the time from removal of the organ from the donor to implantation in the recipient, that may not exceed 6 hours.
As part of the project of the Russian Foundation for Basic Research “MicroRNA 223-5p and -3p-dependent mechanisms of necroptosis in the myocardium of heart allograft in heart transplantation”, a group of scientists from Almazov Centre supervised by the Director of the Institute of Experimental Medicine, Prof. Mikhail Galagudza composed a cardioplegic solution (used for protecting the myocardium in the lack of blood flow) with low toxic and highly active chemical compounds that inhibit the most formidable type of programmed cell death in the myocardium – necroptosis.
They studied the effect of adding these compounds to a cardioplegic solution on the molecular biological processes in the myocardium, as well as its morphofunctional state in experiments on the transplantation of donor hearts in rats.
The experimental results convincingly demonstrated a significant improvement in the contractility of the myocardium and a decrease in its damage when chemical compounds inhibiting necroptosis were added to the standard cardioplegic solution. Thanks to this study, in the future it will be possible to improve myocardial protection during myocardial revascularization and heart transplantation, as well as to increase the number of donor hearts suitable for use.