| Cardiomyocyte apoptosis and ischemic preconditioning in open heart operations. | |
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MedLine Citation:
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PMID: 12902099 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The aim of the present study was to ascertain the percentage of left apical myocardial apoptosis in three-vessel coronary artery bypass grafting patients quantitatively and the impact of ischemic preconditioning. METHODS: Twenty-one patients with three-vessel disease who had elective coronary artery bypass grafting were randomized in a ratio of 2:1 to ischemic preconditioning (n = 14) or a control group (n = 7). The ischemic preconditioning protocol was established by two cycles of ascending aorta occlusion for 2 minutes followed by 3 minutes of reperfusion. Myocardial samples from the apex of the left ventricle were taken using a Tru-Cut needle before aortic cross-clamping and immediately after declamping. The percentage of apoptosis was analyzed by TUNEL methods. Data on hemodynamics and biochemical markers were collected. RESULTS: Low levels of myocardial apoptosis were found before the operation (0.01% +/- 0.00%). During the early reperfusion period, the percentage of myocardial apoptotic cells significantly increased (0.15% +/- 0.05%, p = 0.008). Ischemic preconditioning significantly improved cardiac index and right ventricular ejection fraction recovery after the operation (p = 0.036 and 0.001 respectively, repeated measure) but had no effect on myocardial apoptosis before and after the operation (0.01 +/- 0.00 versus 0.01 +/- 0.00, p = 0.658 and 0.12% +/- 0.04% versus 0.23% +/- 0.14%, p = 0.302). CONCLUSIONS: Cardioplegic myocardial ischemia during open heart operation was associated with induction of cardiomyocyte apoptosis in humans. Attenuation of postoperative cardiac dysfunction by ischemic preconditioning appeared to be independent of apoptosis. |
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Authors:
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Zhong-Kai Wu; Jari Laurikka; Antti Saraste; Ville Kytö; Erkki J Pehkonen; Timo Savunen; Matti R Tarkka |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 76 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2003 Aug |
Date Detail:
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Created Date: 2003-08-06 Completed Date: 2003-09-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 528-34 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiac Surgery, Department of Surgery, Tampere University Hospital, Tampere, Finland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Apoptosis / physiology* Biological Markers / analysis Cardiopulmonary Bypass Coronary Artery Bypass / methods* Coronary Disease / surgery Creatine Kinase / blood Female Follow-Up Studies Hemodynamics Humans In Situ Nick-End Labeling Ischemic Preconditioning, Myocardial* Male Middle Aged Myocardial Reperfusion Injury / prevention & control* Myocardium / cytology, pathology* Preoperative Care / methods Probability Reference Values Risk Assessment Treatment Outcome Troponin I / blood Ventricular Function, Left |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Troponin I; EC 2.7.3.2/Creatine Kinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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