Document Detail


Myocardial protection during cardiac surgery from the viewpoint of coronary endothelial function.
MedLine Citation:
PMID:  10549406     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
1. During cardiac surgery, the heart is arrested and subject to ischaemia-reperfusion injury. 2. To protect the heart, cardioplegia is usually used to initially stop and then maintain the still condition of the heart, which not only facilitates the precise operation but, more importantly, minimizes the energy consumption of the heart during this period. 3. The ischaemia-reperfusion injury may involve both myocytes and coronary endothelium-smooth muscle and, therefore, the protection of the heart should also involve these two aspects. 4. Injury to the heart involves: (i) ischaemia-reperfusion injury to the myocytes and coronary circulation; and (ii) possible injury to the coronary circulation by cardioplegia due to its hyperkalaemic components. 5. Injury to the coronary circulation may involve both endothelium-derived nitric oxide (EDNO) and endothelium-derived hyperpolarizing factor (EDHF) mechanisms. The EDNO mechanism is susceptible to ischaemia-reperfusion, whereas the EDHF mechanism may be altered by hyperkalaemic cardioplegia. 6. To further protect the heart, supplemental therapy for EDNO and optimizing the components of cardioplegia to restore the EDHF mechanism may be important.
Authors:
G W He
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Publication Detail:
Type:  Lectures; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Clinical and experimental pharmacology & physiology     Volume:  26     ISSN:  0305-1870     ISO Abbreviation:  Clin. Exp. Pharmacol. Physiol.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-12-16     Completed Date:  1999-12-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0425076     Medline TA:  Clin Exp Pharmacol Physiol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  810-4     Citation Subset:  IM    
Affiliation:
Division of Cardiothoracic Surgery, Grantham Hospital, University of Hong Kong, Hong Kong. gwhe@hkucc.hku.hk
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiac Surgical Procedures / methods*
Endothelium, Vascular / physiology*
Heart Arrest, Induced / methods*
Humans
Myocardial Reperfusion Injury / physiopathology,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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