Effects of alcohol on pericardial adhesion formation in hypercholesterolemic swine

Abstract

Objective: Reoperative cardiac surgery is complicated in part because of extensive adhesions encountered during the second operation. The purpose of this study was to examine the effects of alcohol with and without resveratrol (red wine vs vodka) on postoperative pericardial adhesion formation in a porcine model of hypercholesterolemia and chronic myocardial ischemia.

Methods: Male Yorkshire swine were fed a high-cholesterol diet to simulate conditions of coronary artery disease followed by surgical placement of an ameroid constrictor to induce chronic ischemia. Postoperatively, control pigs continued their high-cholesterol diet alone, whereas the 2 experimental groups had diets supplemented with red wine or vodka. Seven weeks after ameroid placement, all animals underwent reoperative sternotomy.

Results: Compared with controls, pericardial adhesion grade was markedly reduced in the vodka group, whereas there was no difference in the wine group. Intramyocardial fibrosis was significantly reduced in the vodka group compared with controls. There was no difference in expression of proteins involved in focal adhesion formation between any groups (focal adhesion kinase, integrin alpha-5, integrin beta-1, paxillin, vinculin, protein tyrosine kinase 2, protein kinase C ε, and phosphorylated protein kinase C ε). The wine group exhibited elevated C-reactive protein levels versus the control and vodka groups.

Conclusions: Postoperative vodka consumption markedly reduced the formation of pericardial adhesions and intramyocardial fibrosis, whereas red wine had no effect. Analysis of protein expression did not reveal any obvious explanation for this phenomenon, suggesting a post-translational effect of alcohol on fibrous tissue deposition. The difference in adhesion formation in the vodka versus wine groups may be due to increased inflammation in the wine group.

Figure 1

Pericardial adhesions seen 7 weeks after ameroid placement during re-operative sternotomy in Control and Red Wine groups, A. Lack of pericardial adhesions observed in the Vodka group, B. Pericardial adhesion grade significantly reduced in Vodka group as compared to Control or Red Wine groups, C.

Figure 2

Trichrome staining showing intramyocardial collagen deposition (blue stain) replacing normal myocardium (red) of controls, A. Comparatively less collagen deposition is seen in Red Wine group, B, and minimal collagen deposition is seen in Vodka group, C. Analysis of the percent of intramyocardial fibrosis was significantly reduced in the Vodka group compared to controls, D.

Figure 3

Expression of proteins involved in cell-ECM focal adhesion formation. There were no significant differences between groups. Levels represent fold change (FC) in mean as compared to controls.

Figure 4

Blood alcohol levels higher in the Red Wine group compared to the Vodka group.

Figure 5

CRP levels elevated in Red Wine group at re-operation, A. Changes in CRP significantly higher (*p < 0.05) in Red Wine group compared to Vodka group or Controls, B.