All animal procedures in this study were strictly performed in accordance with the Institutional Animal Care and Use Committee (IACUC) guidelines approved by the Ethics Committee of Deqing People's Hospital. The study used 8-12-week-old male C57BL/6 mice purchased from GemPharmatech Co., Ltd. All animals were housed in SPF-grade barrier facilities with environmental parameters meeting national standards (room temperature 22 ± 2 °C, relative humidity 50 ± 10%, 12/12-h light/dark cycle). Throughout the experiments, this study rigorously adhered to the "3R" principles (Replacement, Reduction, Refinement) and implemented standard procedures, including anesthesia and analgesia to minimize animal suffering.
NOTE: Briefly, the intact heart is rapidly excised from the murine thoracic cavity and subjected to retrograde perfusion with collagenase type II solution via the Langendorff apparatus to enzymatically digest the extracellular matrix. Following complete tissue digestion, the softened myocardium is carefully dissociated into a single-cell suspension. The resulting cell suspension is sequentially filtered to remove undigested tissue fragments, followed by gravity sedimentation to enrich viable cardiomyocytes. The purified cardiomyocytes can then be utilized for subsequent experimental applications.
1. Langendorff perfusion device preparation
NOTE: The Langendorff system has a total tubing volume of 15.5 mL. Perfusion flow rate is 3.5 mL/min for cardiac perfusion and 10-15 mL/min for system flushing.
- Flush the Langendorff perfusion system with 50 mL of 75% ethanol.
NOTE: Perform monthly glass tubing cleaning with 1 M HCl to ensure sterility.
- Rinse with 250 mL of sterile ddH2O to remove ethanol residues and eliminate air bubbles.
- Set the water bath temperature to 42 °C. Turn on the pump to initiate circulating heating and fill the external cavity of the Serpentine tube with warm water.
NOTE: This ensures perfusate reaches the heart at 37 °C.
2. Buffer preparation
- Prepare Krebs-Bicarbonate solution buffer (KB), perfusion buffer (PB), digestion buffer (DB), myocyte plating medium (MPM), and myocyte culture medium (MCM) according to the formulations listed in Table 1.
NOTE: Prepare fresh on the day of use.
- Precool 10 mL of KB buffer on ice.
- Fill the lumen with PB. Set the flow rate to 3.5 mL/min and measure effluent temperature (37 °C is optimal).
- Flush 7 mL of DB into the pipeline, and then close the perfusion line.
- Prepare a heparin sodium solution (0.5%, 62.5 KU) and load 300 µL into an insulin syringe.
- Aliquot 10 mL of PB and 10 mL of KB into two separate Petri dishes and pre-chill them on ice.
- Place a 100 µm cell strainer on the lid of a 50 mL centrifuge tube, pre-wet it with 1 mL of KB, and secure it on a 50 mL centrifuge tube.
3. Cardiac extraction and cannulation
NOTE: In this protocol, sterile gloves, instruments, gauze, and cotton swabs were used throughout the procedure to minimize external contamination. While full aseptic technique is essential for primary cell culture, here it served to support animal welfare and tissue integrity for downstream histological and molecular analyses, rather than to maintain sterility for cell isolation.
- Anesthetize the mouse via intraperitoneal injection of 80 mg/kg pentobarbital sodium (pharmaceutical grade) combined with 5 IU/g body weight heparin sodium. Closely monitor until deep anesthesia is achieved. Pinch the mouse's toes and observe the disappearance of the toe-pinch reflex to confirm the success of anesthesia.
- Remove thoracic hair using depilatory cream.
- Fix the mouse on a foam board and disinfect the chest skin with 75% alcohol.
- Lift the thoracic skin with forceps, and make an incision at the xiphoid process.
- Elevate the xiphoid and cut the ribs bilaterally toward the axillary regions, then completely transect the diaphragm.
NOTE: Avoid damaging the heart.
- Immobilize the sternum and ribs using hemostatic forceps to fully expose the heart.
- Absorb blood, and gently displace the liver toward the hindlimbs with tissue. Use cotton swabs carefully to manipulate the heart to expose the inferior vena cava.
- Inject 300 µL of heparin sodium solution (from step 2.5) into the inferior vena cava using the prepared insulin syringe.
NOTE: Take care to prevent air bubble introduction.
- Excise the thymic tissue, then sever the surrounding veins and arteries. Transfer the heart to pre-chilled PB buffer (from step 2.6) immediately.
NOTE: Thymus removal improves aortic visibility. Preserve an aortic segment during excision. Myocardial contraction was slowed by precooled PB solution. Cardiac excision under anesthesia achieves humane euthanasia.
- Using microforceps, grasp the aorta and mount it onto the cannula of the Langendorff perfusion system. Secure with 5-0 silk suture.
NOTE: Perform this step rapidly. Ensure the perfusion system is turned off during heart mounting.
4. Cardiac perfusion
- Turn on the perfusion system and initiate timing for 2 min and 30 s. During this period, the effluent consists of PB buffer and does not require collection.
- Upon completion of the 2 min and 30 s interval, begin collecting and recirculating the DB buffer while timing for 15 min.
NOTE: Monitor myocardial status - optimal digestion is indicated by reduced tissue elasticity and increased translucency. If digestion appears incomplete, the duration may be moderately extended, but should not exceed 20 min total to prevent cardiomyocyte damage.
- After the timed period, switch from DB to PB buffer and continue perfusion for an additional 4 min and 30 s. The effluent during this phase contains DB buffer; collect it.
- Terminate the perfusion by turning off the system after the final timing interval.
5. Cell dissociation and purification
- Remove the heart from the cannula and transfer it into the pre-chilled KB buffer (prepared in step 2.6).
NOTE: Enzymatic digestion was terminated by immediate transfer of the heart into the KB buffer. This rapidly dilutes the residual enzyme, preventing over-digestion and ensuring high cell viability.
- Using fine scissors, carefully excise the atrial and aortic tissues, retaining only the myocardium.
- Mechanically dissociate the myocardial tissue into small fragments (<1 mm3) using microforceps.
- Gently blow off the tissue fragments using a 2 mL dropper to achieve a single-cell suspension.
NOTE: Exercise extreme care during blowing to preserve rod-shaped cardiomyocyte morphology. Avoid using standard pipette tips, as their narrow bore may mechanically disrupt cellular integrity.
- Filter the resulting cell suspension through the pre-wetted 100 µm cell strainer (assembled in step 2.7) into a 50 mL tube.
- Transfer the filtered suspension to a 15 mL tube and allow cardiomyocytes to settle by gravity sedimentation (15 min, 4 °C).
NOTE: The reduced basal surface area of 15 mL tubes significantly enhances cell recovery efficiency compared to 50 mL tubes.
- Carefully aspirate the supernatant, resuspend the pelleted cardiomyocytes in 10 mL of ice-cold KB buffer using a 2 mL transfer pipette, and repeat sedimentation (15 min, 4 °C).
- Repeat steps 5.4-5.7 to obtain a purified preparation of intact, rod-shaped cardiomyocytes suitable for applications.
6. Cell culture
- Coat the culture dishes with 10 µg/mL laminin and incubate at 37 °C for 2 h.
NOTE: To minimize mechanical damage to rod-shaped cardiomyocytes and reduce the extended processing time associated with differential plating, this study employed laminin coating instead of differential plating, a strategy that not only enhances cellular attachment efficiency but also preserves the native physiological characteristics of cardiomyocytes.
- Resuspend cardiomyocytes in 4 mL of pre-warmed (37 °C) MPM. After removing the laminin solution, seed the cardiomyocytes in the coated dishes. Incubate at 37 °C with 2% CO2 for 1 h. Observe cell morphology, size, and density under a microscope.
- After incubation, carefully decant the MPM and replace it with pre-warmed (37 °C) MCM. Maintain incubation at 37 °C with 2% CO2 for 24 h.
- After 24 h, examine the cardiomyocytes for structural integrity and morphology.
NOTE: Maintain strict aseptic technique throughout the procedure.
CAUTION: Collagenase type II may cause respiratory allergies, skin, and eye irritation. Be sure to operate in a well-ventilated area and avoid inhaling dust or coming into contact with skin and mucous membranes. All discarded mouse cardiac tissues, blood samples, and any disposable supplies that have come into contact with them must be collected as biohazardous waste in dedicated, leak-proof containers marked with the biohazard symbol. These materials are subsequently subjected to centralized decontamination and disposal procedures.