The acute cardioprotective effect of glucocorticoid in myocardial ischemia–reperfusion injury occurring during cardiopulmonary bypass

被引:2
作者
Yavuz Enc
Pelin Karaca
Umut Ayoglu
Gercek Camur
Erol Kurc
Sertac Cicek
机构
[1] Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center,
来源
Heart and Vessels | 2006年 / 21卷
关键词
Cardioprotection; Corticosteroid; Myocardium; Ischemia–reperfusion injury;
D O I
暂无
中图分类号
学科分类号
摘要
The purpose of this study was to evaluate the acute cardioprotective effect of high-dose methylprednisolone (25 mg/kg) in the controlled in vivo model of myocardial ischemia–reperfusion injury occurring during cardiopulmonary bypass. Forty nondiabetic male patients with three-vessel disease undergoing first-time bypass surgery were enrolled for this double-blind prospective study. Patients were randomized to be given 25 mg/kg methylprednisolone (Group I) and saline (Group II) 1 h before cardiopulmonary bypass. The levels of cardiac troponin-I (cTnI) were used as a marker of myocardial tissue damage in myocardial ischemia–reperfusion injury. The cTnI levels were measured before surgery, at the second hour after cardiopulmonary bypass, at the 6th and 24th hours, and 5th day postoperatively. There was no significant difference between the two groups in respect to the duration of ischemia and reperfusion. The preoperative cTnI levels were 0.22 ± 0.29 ng/ml in Group I and 0.23 ± 0.28 ng/ml in Group II. cTnI levels increased to 2.40 ± 1.0 ng/ml in Group I and 3.19 ± 0.88 ng/ml in Group II at the 2nd hour after cardiopulmonary bypass. When the differences between T1 and T0 level that showed the amount of troponin release occurring due to ischemia–repefusion injury was calculated and then compared, there was a significant difference between Groups I and II (P = 0.024). The cTnI levels measured at 6 h after CPB were 1.98 ± 0.63 ng/ml in Group I and 2.75 ± 1.15 ng/ml in Group II (P = 0.049). cTnI levels decreased to 0.22 ± 0.10 ng/ml in Group I and 0.49 ± 0.25 ng/ml in Group II on the postoperative day 5 (P = 0.0001). Univalent regression analysis showed that preoperative high-dose corticosteroid usage decreased the troponin release in about 12% and this effect was statistically significant (R2 = 0.12, P < 0.05). A single dose of intravenous methylpredisolone (25 mg/kg) given 1 h before ischemia reduced myocardial ischemia–reperfusion injury. These results demonstrated that the acute cardioprotective effect of corticosteroids has much potential in the future for reducing ischemia–reperfusion injury occurring during cardiopulmonary bypass when it is inevitable.
引用
收藏
页码:152 / 156
页数:4
相关论文
共 173 条
[1]  
Libby P(1973)Reduction of experimental myocardial infarct size by corticosteroid administration J Clin Invest 52 599-607
[2]  
Maroko PR(1974)Protective action of methylprednisolone on the myocardium during experimental myocardial ischemia in the cat Circ Res 35 44-51
[3]  
Bloor CM(2000)Adverse effects of corticosteroids on the cardiovascular system Can J Cardiol 16 505-511
[4]  
Soble BE(1989)Enzyme linked immunoassay of cardiac troponin T for the detection of acute myocardial infarction in patients J Mol Cell Cardiol 21 1349-1353
[5]  
Baraunwald E(1992)Development of monoclonal antibodies for an assay of cardiac troponin-I and preliminary in suspected cases of myocardial infarction Clin Chem 38 2203-2214
[6]  
Spath JA(1992)Development and in vitro characterization of a new immunoassay of cardiac troponin T Clin Chem 38 386-393
[7]  
Lane DL(1991)Troponin T to diagnose myocardial infarction in bypass surgery Lancet 337 334-335
[8]  
Lefer AM(2002)Acute cardiovascular protective effects of corticosteroids are mediated by non-transcriptional activation of endothelial nitric oxide synthase Nat Med 8 473-479
[9]  
Sholter DE(1986)In vivo protein-DNA interactions in a glucocorticoid response element require the presence of the hormone Nature 324 686-688
[10]  
Armstrong PW(1995)Nitric oxide and vascular disease N Engl J Med 333 251-253