Cerebral Ischemia and Reperfusion: Prevention of Brain Mitochondrial Injury by Lidoflazine

<jats:p>Mitochondrial degradation is implicated in the irreversible cell damage that can occur during cerebral ischemia and reperfusion. In this study, the effects of 10 min of ventricular fibrillation and 100 min of spontaneous circulation on brain mitochondrial function was studied in dogs in the absence and presence of pretreatment with the Ca<jats:sup>2+</jats:sup>antagonist lidoflazine. Twenty-three beagles were separated into four experimental groups: (i) nonischemic controls (ii) those undergoing 10-min ventricular fibrillation, (iii) those undergoing 10-min ventricular fibrillation pretreated with 1 mg/kg lidoflazine i.v., and (iv) those undergoing 10-min ventricular fibrillation followed by spontaneous circulation for 100 min. Brain mitochondria were isolated and tested for their ability to respire and accumulate calcium in a physiological test medium. There was a 35% decrease in the rate of phosphorylating respiration (ATP production) following 10 min of complete cerebral ischemia. Those animals pretreated with lidoflazine showed significantly less decline in phosphorylating respiration (16%) when compared with nontreated dogs. Resting and uncoupled respiration also declined following 10 min of fibrillatory arrest. One hundred minutes of spontaneous circulation following 10 min of ventricular fibrillation and 3 min of open-chest cardiac massage provided complete recovery of normal mitochondrial respiration. Energy-dependent Ca<jats:sup>2+</jats:sup>accumulation by isolated brain mitochondria was unimpaired by 10 min of complete cerebral ischemia. However, by 100 min after resuscitation, there was a small, but significant rise in the capacity for mitochondrial Ca<jats:sup>2+</jats:sup>sequestration when compared to either control or fibrillated groups. These findings indicate that: (a) 10 min of complete cerebral ischemia causes a substantial decline in the rate at which cortical brain mitochondria can synthesize ATP; (b) pretreatment with lidoflazine significantly protects the ability of brain mitochondria to synthesize ATP following 10-min ventricular fibrillation, (c) mitochondrial damage is completely reversible by 100 min following restoration of circulation, (d) mitochondrial Ca<jats:sup>2+</jats:sup>uptake is relatively insensitive to the adverse effects of ischemia.</jats:p>