دورية أكاديمية
[Myocardial protective effect of L-carnitine in cardioplegia solution on patients undergoing heart valve replacement operation].
| العنوان: | [Myocardial protective effect of L-carnitine in cardioplegia solution on patients undergoing heart valve replacement operation]. |
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| المؤلفون: | Xiang DK; Department of Cardiac Surgery, Guizhou Provincial People's Hospital, Guiyang 550002, China., Yan XZ, Yang SY, Liu XL, Hu XY, Zhou T |
| المصدر: | Zhonghua yi xue za zhi [Zhonghua Yi Xue Za Zhi] 2003 Nov 10; Vol. 83 (21), pp. 1887-90. |
| نوع المنشور: | English Abstract; Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | Chinese |
| بيانات الدورية: | Publisher: Zhonghua yi xue hui Country of Publication: China NLM ID: 7511141 Publication Model: Print Cited Medium: Print ISSN: 0376-2491 (Print) Linking ISSN: 03762491 NLM ISO Abbreviation: Zhonghua Yi Xue Za Zhi Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Beijing : Zhonghua yi xue hui Original Publication: Beijing : Zhonghua yi xue hui. |
| مواضيع طبية MeSH: | Heart Arrest, Induced* , Heart Valve Prosthesis Implantation*, Carnitine/*pharmacology , Heart/*drug effects, Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged |
| مستخلص: | Objective: To investigate the myocardial protective effect of L-carnitine as an ingredient of cardiac arresting solution in the process of heart valve replacement operation. Methods: 69 cases undergoing heart valve replacement with cardiopulmonary bypass (CPB), 47 males and 22 females, aged 48.17 +/- 14.22 (16 approximately 74 years), were divided into 3 groups: test group I (n = 22, 12 g/L L-carnitine was put in the St. Thomas II cold crystal cardiac arresting liquid), test group II (n = 24, 6 g/L L-carnitine was put in the St. Thomas II cold crystal cardiac arresting liquid), and control group (n = 23, no L-carnitine was put in the St. Thomas II cold crystal cardiac arresting liquid). Before operation, 20 minutes after the beginning of shunt, after the finish of shunt, and 8 hours, one day, 3 days, and 7 days after operation venous blood was drawn to test the serum cardial tropnin I (cTnI), aspartate transaminase, lactate dehydrogenase, creatine kinase (CK) and CK-MB isozyme. Heart color ultrasonography was conducted to test the cardiac index (CI) and left heart ejecting fraction (EF) one day before operation and 7 days after operation. Before shunt and by the end of intracardiac procedure a bit of myocardial tissue was taken to undergo electron microscopy. The amounts of vaso-active drugs, such as dopamine and dobutamine, used postoperatively, and the postoperative cardiac auto-rebeating rate were recorded. Results: The Amounts of vaso-active drugs used after operation was 329 +/- 54 mg in the test group I and 339 +/- 47 mg in the test group II, both significantly less than in the control group (669 +/- 56 mg, both P < 0.01) without a significant difference between the 2 test groups. Since the end of CPB to 3 days after operation, the serum levels of cTnI, aspartate transaminase, lactate dehydrogenase, CK and CK-MB isozyme were significantly lower in the 2 test groups than in the control group (P < 0.05 or P < 0.01). The serum level of cTnI in test group I was significantly lower than in the test group II (5.71 +/- 1.14 ng/ml vs 7.87 +/- 1.89 ng/ml 1 day postoperatively (P < 0.05), and 5.01 +/- 0.89 ng/ml vs 7.53 +/- 1.43 ng/ml 3 days postoperatively (P < 0.05). The postoperative cardiac auto-rebeating rate was 87.9% in the test group I and 74.3% in the test group II, both significantly higher than that in the control group (45.7%, P < 0.05 and P < 0.01). Heart color ultrasonogram showed that 7 days postoperatively the CI index was 2.86 +/- 0.55 and 2.74 +/- 0.56 in the 2 test groups, significantly higher than that in the control group (2.11 +/- 0.35, both P < 0.05), and the left heart EF were 64.3 +/- 8.6 and 59.1 +/- 6.7 in the 2 test groups, both significantly higher than that in the control group (51.7 +/- 4.9, both P < 0.05). Electron microscopy showed only slight swelling of mitochondria in the cardial cell and the myocardial fiber was intact by the end of operation in the 2 test groups without significant difference between these 2 groups, however, in the control group swelling of mitochondria with vesicle formation, fissure of part of mitochondrial ridges, and disappearance of glycogen particles were found. Conclusion: Antegrade coronary perfusion of L-carnitine has a good protective effect on myocardium and is worth spreading for heart valve replacement patients with cardiopulmonary bypass. |
| المشرفين على المادة: | S7UI8SM58A (Carnitine) |
| تواريخ الأحداث: | Date Created: 20031203 Date Completed: 20040408 Latest Revision: 20151119 |
| رمز التحديث: | 20231215 |
| PMID: | 14642073 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0376-2491 |
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