Effect of Diabetes on Outcome after Cardiac Arrest and Cardiopulmonary Resuscitation with Postconditioning Strategies in a Rodent Model
Final Report Abstract
Despite advanced treatments in cardiopulmonary resuscitation (CPR) and enhanced research, survival in a good neurologic condition from out-of-hospital cardiac (OHCA) arrest is still less than 10% and has plateaued since 2012. Especially, patients with metabolic syndrome and Type 2 Diabetes Mellitus (T2DM) do not only have a higher risk for cardiac arrest, but also have a decreased chance of survival. Since existing research models rarely take comorbidities into account, the overall goal of my postdoctoral research grant was to establish a new and more relevant research model of cardiac arrest and cardiopulmonary resuscitation in a rodent model with comorbidities. By using Zucker Diabetic Fatty (ZDF) rats, we wanted to evaluate the effect of metabolic syndrome and T2DM on outcome in an animal model with the potential to test new and promising therapies. We hypothesized that T2DM is associated with a lower chance for return of spontaneous circulation (ROSC) and/or a worse outcome regarding heart function after asphyxial CA compared to their lean littermates. Conversely, there was no difference in ROSC rates and the diabetic ZDF rats showed a significantly higher blood pressure related to an increased EF%. In addition Troponin levels were lower in diabetic rats, while neurologic damage marker such as NSE were lower in non-diabetic animals. The improved cardiac function in diabetic rats after cardiac arrest, limited the options to test therapies, but set the base for further examinations exvivo. Another unexpected effect of T2DM was seen in Langendorff-isolated hearts of Zucker Spontaneous Hypertensive (ZSF-1) rats. We were able to show for the first time that adjusting buffer glucose levels to higher levels as seen in the same rat in-vivo, did not worsen the myocardial function in isolated Langendorff-hearts. Therefore, we were not able to conclude that T2DM might have a worsened effect on ischemia-reperfusion injury in experimental models. Overall we were able to work on important steps for the development of new relevant research models.
Publications
- Abstract 328: Hemodynamic Comparison of Zucker Diabetic Fatty Rats to Their Lean Littermates After Asphyxial Cardiac Arrest, Circulation. 2018;138:A328, Chicago
Balzer C, Baudenbacher F, Salzman MM, Cleveland WJ, Eagle S, Riess ML
(See online at https://doi.org/10.1161/circ.138.suppl_2.328) - Abstract 119: Influence of Anesthetics on the Hemodynamic Response in a Rat Model of Hemorrhagic Shock. Circulation. 2019;140(Suppl_2):A119-A
Balzer C, Baudenbacher Franz J, Eagle Susan S, Salzman Michele M, Cleveland William J, Riess Matthias L
(See online at https://doi.org/10.1161/circ.140.suppl_2.119) - Abstract 20: Peripheral Intravenous Analysis Detects Return of Spontaneous Circulation Without Interruption of Chest Compressions in a Rat Model of Cardiopulmonary Resuscitation. Circulation. 2019;140(Suppl_2):A20-A
Balzer C, Baudenbacher Franz J, Hernandez A, Salzman Michele M, Riess Matthias L, Eagle Susan S
(See online at https://doi.org/10.1161/circ.140.suppl_2.20) - Mechanical adjuncts for cardiocerebral resuscitation. Expert Rev Med Devices. 2019;16(9):771–776
Riess ML, Balzer C
(See online at https://doi.org/10.1080/17434440.2019.1649135) - Venous Waveform Analysis Correlates With Echocardiography in Detecting Hypovolemia in a Rat Hemorrhage Model. Semin Cardiothorac Vasc Anesth. 2020;61
Lefevre RJ, Balzer C, Baudenbacher FJ, Riess ML, Hernandez A, Eagle SS
(See online at https://doi.org/10.1177/1089253220960894) - Video laryngoscopic oral intubation in rats: a simple and effective method. Am J Physiol Lung Cell Mol Physiol. 2020;318: L1032-L1035
Balzer C, Cleveland WJ, Jinka TR, Riess ML
(See online at https://doi.org/10.1152/ajplung.00498.2019)
