Myocardial Protection with Blood Cardioplegia in Ischemically Injured Hearts: Reduction of Reoxygenation Injury with Allopurinol
| Autor: | Mark Hartman, William E. Johnston, Kirk B. Faust, Brenda L. McCain, A. Robert Cordell, Jakob Vinten-Johansen, Virginia Chiantella, T. Oma Hester, Stephen A. Mills |
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| Rok vydání: | 1988 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.drug_class Allopurinol Ischemia chemistry.chemical_compound Coronary circulation Dogs Oxygen Consumption Coronary Circulation medicine Animals Cardiac Surgical Procedures Xanthine oxidase Cardioplegic Solutions Xanthine oxidase inhibitor business.industry Heart Stroke Volume Stroke volume Blood flow medicine.disease Blood medicine.anatomical_structure chemistry Anesthesia Heart Arrest Induced Uric acid Female Surgery Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The Annals of Thoracic Surgery. 45:319-326 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(10)62472-1 |
| Popis: | Myocellular injury mediated by oxygen radicals potentially limits myocardial protection in ischemically damaged hearts. This damage may be greater with oxygen-carrying blood cardioplegic solutions. A major mechanism of oxygen radical production is the conversion of hypoxanthine to uric acid by xanthine oxidase. In 16 anesthetized dogs, we studied whether adding allopurinol, a xanthine oxidase inhibitor, to blood cardioplegia would improve recovery of left ventricular (LV) performance and oxygen consumption. Millar transducer-tipped catheters and minor axis ultrasonic crystals were placed to assess LV performance by the slope of the end-systolic pressure-minor axis diameter relationships (Emax). Following total vented bypass, the hearts underwent 30 minutes of normothermic ischemia and then hypothermic blood cardioplegia with 1 mM allopurinol (N = 8) or without allopurinol (N = 8). Postischemic LV performance was significantly better with allopurinol than without (49.5 +/- 8.0 versus 17.4 +/- 4.1% of preischemic Emax; p less than 0.004). Postischemic LV oxygen consumption in the beating working state, calculated from LV blood flow (15 microm microspheres) and oxygen extraction, was comparable to preischemic values with and without allopurinol (10.2 +/- 1.2 versus 8.6 +/- 1.2 ml O2/100 gm/min). We conclude that allopurinol enhancement of blood cardioplegia increases myocardial protection in severely ischemic ventricles. |
| Databáze: | OpenAIRE |
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