Myocardial oxidative stress, and cell injury comparing three different techniques for coronary artery bypass grafting
Autor: | Wim-Jan van Boven, Wim B.M. Gerritsen, Frans G.J. Waanders, Wim J. Morshuis, Fred J. L. M. Haas, Eric P.A. van Dongen, Antoine H.G. Driessen, Leon Aarts |
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Rok vydání: | 2007 |
Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Coronary Artery Disease chemistry.chemical_compound Coronary artery bypass surgery Troponin T Internal medicine Malondialdehyde medicine Humans Prospective Studies Coronary Artery Bypass Creatine Kinase Coronary sinus Aged Aged 80 and over Cardiopulmonary Bypass biology business.industry Myocardium General Medicine Middle Aged medicine.disease Troponin Oxidative Stress medicine.anatomical_structure Treatment Outcome chemistry Heart-type fatty acid binding protein biology.protein Cardiology Surgery Female Cardiology and Cardiovascular Medicine business Reperfusion injury Biomarkers Artery |
Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 34(5) |
ISSN: | 1873-734X |
Popis: | Objective: Oxidative stress as a result of reperfusion injury is a known causative factor of cardiac muscle injury. In the peripheral blood as well in the coronary sinus, oxidative stress parameters and cardiac biomarkers were measured to investigate the different levels of oxidative stress during three different CABG techniques; MCABG (with minimal prime volume and warm blood cardioplegia) that was newly introduced in our hospital, versus OPCAB, versus our current standard, conventional CABG (CCABG, consisting of high volume prime and cold crystalloid cardioplegia). Concomitantly, cardiac biomarkers were measured to detect myocardial cell injury. Methods: Thirty patients scheduled for CABG with the intention to treat three-vessel disease were randomly assigned for CCABG, MCABG or OPCAB. Perioperatively, plasma levels of malondialdehyde (MDA) as a marker of oxidative stress, and the allantoin/uric acid ratio (A/U ratio) as a marker of antioxidant activity were measured in the ascending aorta (Aa), and in the coronary sinus (Cs), simultaneously. Additionally peripheral (Aa) blood levels of heart fatty acid binding protein (HFABP), troponin T, CPK and CKMB as markers of myocardial injury were obtained. Results: The MCABG group had significantly lowerMDAlevelsintheCscomparedtotheCCABGgroup,respectively,to theOPCABgroup(p = 0.04andp = 0.03).AtalltimepointstheA/Uratio in the CCABG group remained significantly higher in the Cs as well in the Aa samples compared to the MCABG and the OPCAB group (p < 0.001, respectively, p < 0.001, for both groups). HFABP and troponin Tshowed consistent curves compared to the CPK figure over time in all groups. Conclusion:In this study coronary sinus blood levels of oxidative stress parameters were consistently higher compared to peripheral blood levels. The levels were lowest in the MCABG study group. In this group also the lowest levels cardiac biomarkers of myocardial injury were found. # 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. |
Databáze: | OpenAIRE |
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