Document Detail

Experimental investigation of "hANP shot" using human atrial natriuretic peptide for myocardial protection in cardiac surgery.
MedLine Citation:
PMID:  22436291     Owner:  NLM     Status:  Publisher    
BACKGROUND: We investigated myocardial protection by human atrial natriuretic peptide (hANP) during cardiac surgery without cardioplegia and determined whether suppression of myocardial ischemic reperfusion injury by hANP allows intraoperative aortic cross-clamp time to be prolonged. METHODS AND RESULTS: Thirty-two pigs were placed on cardiopulmonary bypass. Experimental pigs were divided into 4 groups: 15min clamping; hANP 15min clamping; 30min clamping; and hANP 30min clamping. In both hANP groups, a 100μg dose of hANP was administered after clamping. Left ventricular function, premature ventricular contractions (PVCs), histopathological studies, 8-isoprostane, myocardial Ca(2+), and ATP concentrations were determined. Comparison of the myocardial contractile force indicator E(max), in the 30min groups, showed a significantly higher recovery rate in the hANP than in the control group. PVC numbers were significantly lower in the hANP than in the control groups for both arrest durations. On microscopic examination, hANP reduced ischemic reperfusion injury in the 30min groups. The myocardial ATP level was significantly higher in the hANP 30min than in the control 30min group. Increases in 8-isoprostane and myocardial Ca(2+) concentrations were significantly inhibited in both hANP groups. CONCLUSIONS: This study demonstrated that hANP ameliorates ischemic reperfusion injury, improves postoperative myocardial contractility, and reduces reperfusion arrhythmias. We suggest that hANP allows aortic cross-clamping to be prolonged and thereby exerts a direct myocardial protective effect against cardiac arrest during cardiac surgery.
Shunji Osaka; Akira Sezai; Shinji Wakui; Kazuma Shimura; Yoshiki Taniguchi; Mitsumasa Hata; Motomi Shiono
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-19
Journal Detail:
Title:  Journal of cardiology     Volume:  -     ISSN:  1876-4738     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
The Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
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