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The myocardial protection of polarizing cardioplegia combined with delta-opioid receptor agonist in Swine.
MedLine Citation:
PMID:  21619990     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to determine whether polarized arrest using adenosine/lidocaine cold crystalloid cardioplegia in combination with the hibernation inductor δ-opioid receptor agonist pentazocine would give satisfactory myocardial protection rather than using depolarized supranormal potassium cardioplegia, supranormal potassium cardioplegia with pentazocine, or adenosine/lidocaine cardioplegia.
METHODS: Twenty pigs were randomly divided into four groups (n = 5 each) to receive the four types of cold crystalloid cardioplegia with an aortic cross-clamp time of 1 hour. Hemodynamic data were continuously measured, as was the left ventricular end-diastolic pressure (LVEDP), left ventricular end-systolic pressure (LVESP), plus or minus derivative of change in diastolic pressure over time (±dp/dt), cardiac output, pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac troponin I, and left ventricular ultrastructure.
RESULTS: Both the adenosine/lidocaine/pentazocine group and the adenosine/lidocaine group got significantly better results than the hyperkalemic and hyperkalemic pentazocine groups in improving hemodynamic values, pulmonary capillary wedge pressure, LVEDP, LVESP, ±dp/dt, cardiac output, cardiac troponin I values, and left ventricular ultrastructure. There were no statistical differences between the adenosine/lidocaine/pentazocine group and the adenosine/lidocaine group at 1 hour after cross-clamp removal; but at 2 hours after cross-clamp removal, the adenosine/lidocaine/pentazocine group stands out (LVEDP 3.3 ± 0.5, LVESP 122.5 ± 18.9, +dp/dt 2.9 ± 0.1, -dp/dt 2.0 ± 0.6, cardiac output 2.6 ± 0.4, and troponin I 4.9 ± 0.5), with significant differences from the adenosine/lidocaine group (LVEDP 5.8 ± 1.0, LVESP 98.5 ± 10.1, +dp/dt 2.5 ± 0.2, -dp/dt 1.0 ± 0.2, cardiac output 2.2 ± 0.2, troponin I 8.2 ± 0.8; p < 0.05). The defibrillation rate was largely decreased after the cross-clamp was released in the group containing pentazocine in cardioplegia.
CONCLUSIONS: Adenosine/lidocaine/pentazocine cold crystalloid cardioplegia gave satisfactory cardiac arrest and better myocardial protection than the other three groups, especially with regard to improving prolonged postoperative cardiac function.
Authors:
Ting Wu; Peiqing Dong; Changcheng Chen; Jing Yang; Xiaotong Hou
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  91     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1914-20     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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