Effects of levocamitine cardioplegic solution on cardio-myocyte apoptosis in patients undergoing heart valve replacement with cardiopulmonary bypas
- VernacularTitle:左-卡尼汀心脏停搏液对心脏瓣膜置换术患者心肌细胞凋亡的影响
- Author:
Daokang XIANG
;
Zongquan SUN
;
Jiahong XIA
- Publication Type:Journal Article
- Keywords:
Carnitine;
Heart valve prosthesis implantation;
Myocardium;
Apoptosis
- From:
Chinese Journal of Anesthesiology
1996;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of levocarnitine used as an ingredient of cardioplegic solution on cardiomyocyte apoptosis in patients undergoing heart valve replacement under cardiopulmonary bypass (CPB) .Methods Twenty-four NYHA grade Ⅱ or Ⅲ patients of both sexes (16 males, 8 females) aged 27-67 yrs undergoing heart valve replacement under CPB were randomly allocated into 2 groups (n = 12): levocarnitine group and control group. In levocarnitine group levocarnitine 6 g was added to 1 000 ml of 4℃ St Thomas Ⅱ cardioplegic solution, while in control group equal volume of normal saline was added instead of levocarnitine. Cardioplegic solution 15 ml?kg-1 was injected to perfuse the heart every 30 min during aortic cross-clamping. The KC1 concentration of the cardioplegic solution was reduced by half for the last injection. During CPB the naso pharyngeal temperature was maintained at 25-27℃. Cardiac index (CI) and left ventricular ejection fraction (LVEF) were measured 1 day before and 7 days after operation using heart color ultrasonography. A small piece of myocardial tissue was obtained from right atrium for assessment of apoptosis using terminal deoxynueleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) . The expression of Bax and Bcl-2 in cardiomyocytes was determined by immuno-histochemistry, and Bcl-2/Bax ratio was calculated. Results The rate of restoration of spontaneous heart beat after aortic unclamping was significantly higher in levocarnitine group than in control group (86.6% vs 47.3%) (P
