AUTHOR=Mourouzis Iordanis , Anagnostopoulos Dimitris , Brozou Vassiliki , Kounatidis Dimitris , Giannoulis Dimitris , Lourbopoulos Athanasios , Saranteas Theodosios , Pantos Constantinos TITLE=Ex vivo rat heart normothermic perfusion with intermittent low flow and triiodothyronine JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=Volume 12 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1607594 DOI=10.3389/fcvm.2025.1607594 ISSN=2297-055X ABSTRACT=BackgroundIschemia-reperfusion injury remains the main constraint of normothermic perfusion. The present study investigated the potential of therapies targeting reperfusion injury such as triiodothyronine and interventions mimicking ischemic preconditioning (PC) to optimize normothermic crystalloid perfusion.MethodsRat hearts were perfused for 6 h with constant flow, in a Langendorff mode and Krebs-Henseleit as perfusate with glucose being the only metabolic substrate, (NP, n = 9). PC treated hearts were subjected to 5 cycles of 40 min low flow perfusion followed by 20 min normal flow perfusion with either vehicle (PC, n = 11) or 60nM T3 (PC + T3, n = 10). Left ventricular end diastolic pressure (LVEDP), left ventricular developed pressure (LVDP), perfusion pressure (PP), and percentage of change of these parameters from baseline values were measured. The ratio of LV weight to body weight was calculated as index of tissue edema.ResultsBaseline parameters were similar between groups. At the end of perfusion, no difference in LVDP was observed, LVEDP was significantly lower in PC and PC + T3 vs. NP, p < 0.05. PP was significantly lower in both PC and PC + T3 vs. NP hearts. p < 0.05. Both PC and PC + T3 significantly reduced tissue edema.ConclusionIntermittent low flow mimicking ischemic preconditioning (PC) appears to optimize crystalloid based normothermic rat heart perfusion by limiting tissue edema and diastolic and vascular dysfunction.