Document Detail

Myocardial metabolism on off-pump surgery; a randomized study of 50 cases.
MedLine Citation:
PMID:  12944209     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the inflammatory reaction and myocardial metabolism in off-pump and on-pump coronary artery bypass patients. DESIGN: Fifty coronary artery bypass patients were randomized to off-pump or on-pump operations. Myocardial biopsies were taken to determine myocardial metabolism and inflammation (glutathione (GSH), superoxide dismutase (SOD) and myeloperoxidase (MP)) and plasma samples for indicators of oxidative stress (conjugated dienes (s-BDC), oxidative products of proteins (s-ox-Prot) and low-density lipoprotein (LDL)-total peroxyl radical trapping antioxidant potential (s-TRAP)). RESULTS: s-ox-Prot 10 min was 2.11 +/- 0.75 vs 2.69 +/- 0.60 (p = 0.014), s-TRAP 5 min was 861 +/- 180 vs 969 +/- 192 (p = 0.032) and s-TRAP 10 min 857 +/- 176 vs 985 +/- 166 (p = 0.011), GSH 10 min 0.55 +/- 0.19 vs 0.72 +/- 1.16 (p = 0.007) (off-pump vs on-pump). The monobasic (MB) fraction of the creatinine kinase 24 h after the operation was significantly lower in the off-pump group, 20.5 +/- 24.2 vs 61.8 +/- 84.6 (p = 0.023). CONCLUSION: GSH levels from the biopsies were increased in the perfusion group early in the reperfusion time showing that myocardial tissue was well protected and recovered more rapidly after cross-clamping than after the occlusion of the coronary arteries. However, release of creatinine kinase was lower in the off-pump group showing that cardiopulmonary bypass has more deleterious effects later after the operation.
A Sahlman; J Ahonen; A Nemlander; M Salmenperä; H Eriksson; J Rämö; A Vento
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  37     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-28     Completed Date:  2004-04-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  211-5     Citation Subset:  IM    
Department of Thoracic Surgery, Helsinki University Central Hospital, Hus, Finland.
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MeSH Terms
Biological Markers / blood
Coronary Artery Bypass*
Coronary Artery Disease / metabolism,  physiopathology,  surgery
Coronary Circulation / physiology
Creatine Kinase / metabolism
Creatine Kinase, MB Form
Glutathione / metabolism
Isoenzymes / metabolism
Middle Aged
Myocardial Reperfusion
Myocardium / metabolism*
Peroxidase / metabolism
Postoperative Complications / etiology,  metabolism,  physiopathology
Superoxide Dismutase / metabolism
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 70-18-8/Glutathione; EC; EC Dismutase; EC Kinase; EC Kinase, MB Form

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