Document Detail


"Polarizing" microplegia improves cardiac cycle efficiency after CABG for unstable angina.
MedLine Citation:
PMID:  22795715     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Myocardial protection during coronary artery bypass grafting (CABG) for unstable angina (UA) still represents a major challenge, ought to the risk for further ischemia/reperfusion injury. Few studies investigate the biochemical, hemodynamic and echocardiographic results of microplegia (Mic) in UA. METHODS: Eighty UA-patients undergoing CABG were randomized to Mic (Mic-Group) or standard 4:1 blood Buckberg-cardioplegia (Buck-Group). Troponin-I and lactate were sampled from coronary sinus at reperfusion (T1), and from peripheral blood preoperatively (T0), at 6 (T2), 12 (T3) and 48 (T4) hours. Cardiac index (CI), indexed systemic vascular resistances (ISVR), Δp/Δt, cardiac cycle efficiency (CCE), and central venous pressure (CVP) were collected preoperatively (T0), and since Intensive Care Unit (ICU)-arrival (T1) to 24h (T5). Echocardiographic E-wave (E), A-wave (A), E/A, peak early-diastolic TDI-mitral annular-velocity (Ea), and E/Ea investigated the diastolic function and Wall Motion Score Index (WMSI) the systolic function, preoperatively (T0) and at 96h (T1). RESULTS: Mic-Group showed lower troponin-I and lactate from coronary sinus (p=.0001 for both) and during the postoperative course (between-groups p=.001 and .0001, respectively). WMSI improved only after Mic (time-p=.001). Higher CI Δp/Δt and CCE (between-groups p=.0001), with comparable CVP and ISVR (p=N.S.) were detected after Mic. Diastolic function improved in both groups, but better after Mic (between-groups p=.003, .001, and .013 for E, E/A, and Ea, respectively). Mic resulted in lower transfusions (p=.006) and hospitalization (p=.002), and a trend towards lower need/duration of inotropes (p=.04 and p=.041, respectively), and ICU-stay (p=.015). CONCLUSION: Microplegia attenuates myocardial damage in UA, reduces transfusions, improves postoperative systo-diastolic function, and shortens hospitalization.
Authors:
Francesco Onorati; Francesco Santini; Rajesh Dandale; Grazia Ucci; Kostantinos Pechlivanidis; Tiziano Menon; Bartolomeo Chiominto; Alesssandro Mazzucco; Giuseppe Faggian
Related Documents :
10874265 - Reduction in the need for hospitalization for recurrent ischemic events and bleeding wi...
9545145 - Low-molecular-weight heparins in coronary arterial thrombus disease: a review of the li...
11256775 - Low molecular weight heparin for treatment of acute myocardial infarction (fami): fragm...
2382605 - Unstable angina or non-q wave infarction despite long-term aspirin: response to thrombo...
7760515 - Low incidence of hemorrhagic infarction following coronary reperfusion with nasaruplase...
10874265 - Reduction in the need for hospitalization for recurrent ischemic events and bleeding wi...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-12
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ireland Ltd.
Affiliation:
Division of Cardiac Surgery, University of Verona Medical School, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Optimal time for catheterization in NSTE-ACS patients with impaired renal function: Insights from th...
Next Document:  Cardio-cerebrovascular protective effects of valsartan in high-risk hypertensive patients with overw...