Mustafa Barış KEMAHLI, Tuğra GENÇPINAR, Tuğba ERKMEN, Belgin SERT SERDAR, Semra KOÇTÜRK, Kıvanç YÜKSEL, Kıvanç METİN
Journal of Updates in Cardiovascular Medicine - 2026;14(1):17-23
Objectives: Myocardial ischemia-reperfusion injury remains a major source of morbidity in cardiac surgery, and novel strategies for cardioprotection are needed. Preoperative dietary modulation has been proposed as a feasible approach to enhance myocardial resilience. This study investigated the effects of preoperative plant-based versus animal-based diets (ABD) on myocardial protection in a rat model of cardioplegic arrest, with emphasis on apoptosis, oxidative stress, and stress response markers. Materials and Methods: Sixteen male Wistar albino rats were initially randomized to receive either a plant-based diet (PBD) (soy protein, palm oil) or an ABD (casein, milk fat) for 12 weeks. Due to peri-experimental losses, final analyses were performed on 6 rats in the PBD group and on 7 rats in the ABD group. At the end of the feeding period, rats underwent a standardized cardioplegic arrest induced by St. Thomas II crystalloid solution, resulting in 10 minutes of ischemia; blood cardioplegia was then administered prior to tissue harvesting. Left ventricular tissues were harvested for biochemical analysis. Bcl-2 and Bax, glutathione (GSH), protein carbonyls and malondialdehyde (MDA), and heat shock protein 70 (Hsp-70) were measured as markers of apoptosis, redox defense, oxidative damage, and stress response, respectively. Results: Bcl-2 levels were significantly higher in the PBD group compared to the ABD group (11.28+/-1.22 vs. 9.50+/-1.25, p=0.025), indicating enhanced antiapoptotic signaling. Among other markers, Bax, MDA, protein carbonyls, and GSH showed trends favoring the PBD group that were not statistically significant, whereas Hsp-70 levels were numerically higher in the ABD group but not statistically significant. Conclusion: In this experimental rat model of cardioplegic arrest, preoperative plant-based nutrition enhanced antiapoptotic signaling through significant upregulation of Bcl-2, while other oxidative and apoptotic markers showed favorable but not statistically significant trends. These findings suggest that diet composition can influence myocardial resilience to surgical stress, supporting the potential role of plant-based preoperative regimens as an adjunct to established cardioprotective strategies. Further validation in larger studies is warranted.
