Isoflurane preconditioning decreases the plasma concentration of matrix metalloproteinase-9 and protects myocardium against cardiopulmonary bypass in cardiac valve replacement.
- Author:
Wenyan RUAN
1
;
Junmei XU
;
Zhijian LI
;
Miao TAN
;
Ke RAN
Author Information
1. Department of Anesthesiology, Central South University, Changsha 410011, China. ruanwy33@hotmail.com
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Cardiopulmonary Bypass;
Cardiotonic Agents;
therapeutic use;
Female;
Heart Valve Prosthesis Implantation;
methods;
Humans;
Ischemic Preconditioning, Myocardial;
methods;
Isoflurane;
therapeutic use;
Male;
Matrix Metalloproteinase 9;
blood;
Middle Aged;
Myocardium;
ultrastructure;
Young Adult
- From:
Journal of Central South University(Medical Sciences)
2009;34(2):158-164
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the effect of isoflurane preconditioning on the plasma concentration of matrix metalloproteinase (MMP)-9 and myocardial ultramicrostructure in patients undergoing cardiac valve replacement.
METHODS:Thirty patients undergoing elective cardiac valve replacement with cardiopulmonary bypass (CPB) were randomly assigned to a control group (ný15) and an isoflurane group (ný15). In the isoflurane group, isoflurane of 1.0 minimum alveolar concentration end-tidal( 1.1% approximately 1.2%) was administered for 30 min followed by a 15 min washout period before the CPB. The control group did not inhale isofurane, and there was no difference in the other drugs in the 2 groups. Blood samples for MMP-9 were obtained before incision(T(0)) and at 30 min (T(1)),6 h (T(2)),12 h (T(3)), and 24 h (T(4)) after the reperfusion. Right atrial biopsies were collected before and after the CPB to observe the myocardial ultramicrostructure.
RESULTS:Compared with T(0), the mean MMP-9 level significantly increased at T(1), T(2) and T(3) in the control group(P<0.01), while the MMP-9 level only at T(1) significantly increased in the isoflurane group (P<0.01). The mean MMP-9 level was significantly reduced in the isoflurane group at T(2) compared with each time point in the control group. The difference in MMP-9 levels between T(1), T(2), T(3) and T(0) was significantly lower in the isoflurane group than that in the control group (P<0.01). The ultramicrostructure injury of myocardium under electron microscope in the control group was worse than that in the isoflurane group.
CONCLUSION:The plasma concentration of MMP-9 is inhibited by isoflurane preconditioning in patients undergoing cardiac valve replacement after CPB, which might be part of its protective mechanism against myocardium injury after CPB.
