Document Detail

Cardiomyocyte apoptosis and ischemic preconditioning in open heart operations.
MedLine Citation:
PMID:  12902099     Owner:  NLM     Status:  MEDLINE    
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.
Zhong-Kai Wu; Jari Laurikka; Antti Saraste; Ville Kytö; Erkki J Pehkonen; Timo Savunen; Matti R Tarkka
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  76     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-06     Completed Date:  2003-09-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  528-34     Citation Subset:  AIM; IM    
Division of Cardiac Surgery, Department of Surgery, Tampere University Hospital, Tampere, Finland.
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MeSH Terms
Apoptosis / physiology*
Biological Markers / analysis
Cardiopulmonary Bypass
Coronary Artery Bypass / methods*
Coronary Disease / surgery
Creatine Kinase / blood
Follow-Up Studies
In Situ Nick-End Labeling
Ischemic Preconditioning, Myocardial*
Middle Aged
Myocardial Reperfusion Injury / prevention & control*
Myocardium / cytology,  pathology*
Preoperative Care / methods
Reference Values
Risk Assessment
Treatment Outcome
Troponin I / blood
Ventricular Function, Left
Reg. No./Substance:
0/Biological Markers; 0/Troponin I; EC Kinase

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