BACKGROUND: It was reported that N,N,N'N'-tetrakis-[2-pyridylmethyl]-ethylenediamine (TPEN), a transition metal chelator, confers cardioprotection against myocardial ischemic injury. In this study, we investigated the effect of TPEN targeting reperfusion period in isolated rat hearts. METHODS: Langendorff perfused rat hearts were subjected to 30 min of regional ischemia and 2 h of reperfusion. Hearts were randomly assigned to either control (n = 9) or 10 micrometer of TPEN (n = 8) groups. TPEN was perfused for a period of 5 min before and 30 min after reperfusion. RESULTS: The ratio of infarct area/ischemic area (AN/AR) was significantly reduced in TPEN treated hearts (6.9 +/- 1.7%, P < 0.001) compared to control hearts (29.5 +/- 3.2%). Recovery of left ventricular developed pressure (LVDP), rate-pressure product (RPP), +dP/dt(max), and -dP/dt(min) in the control group after reperfusion were 53.8 +/- 6.2%, 51.0 +/- 6.3%, 51.9 +/- 5.7%, and 51.4 +/- 5.7%, respectively, of the baseline levels. In the TPEN group, LVDP, RPP, +dP/dt(max), and -dP/dt(min) returned to 58.5 +/- 4.6%, 54.8 +/- 6.4%, 61.7 +/- 4.9%, and 53.4 +/- 3.9%, respectively, of the baseline levels. There were no significant differences in the cardiodynamic variables between the two groups (P > 0.05). CONCLUSIONS: Pharmacological postconditioning with TPEN reduces myocardial infarction however, TPEN does not modify post-ischemic systolic dysfunction in isolated rat hearts.
Animals ; Ethylenediamines ; Heart ; Ischemia ; Myocardial Infarction ; Myocardial Stunning ; Rats ; Reperfusion ; Reperfusion Injury

The radial artery as a graft for myocardial revascularization was introduced by Carpentier et al. in the early 1970s. Mid-term results were unfortunately discouraging, and the clinical experience with this graft was interrupted. At the end of the 1980s, these authors reproposed the same arterial conduit with more satisfying results, because of improved technique and pharmacological management of the graft. Between October 1994 and July 1995, 36 patients underwent myocardial revascularization with a radial artery graft in Sejong General Hospital. Left internal mammary artery was concomitantly used as a pedicled graft in 34 patients. Fifteen patients(42%) had a complete arterial graft revascularization. A total of 123 distal anastomoses were performed(average 3.4 per patient), including 36 left internal mammary artery grafts(two sequential in 2 patients), and 23 saphenous vein grafts. The remaining 64 distal anastomoses were performed with radial artery grafts (mean 1.8 per patient). The radial arteries were anastomosed to the circumflex(n=38), diagonal( n=18), right coronary(n=6), and left anterior descending coronary artery(n=2). The percentage of radial artery graft anastomoses(64) to the total anastomoses(123) was 52%. The radial artery was used as a single graft in 10 patients, as a sequential graft in 25 patients, and two grafts in 1 patient. Twenty patients underwent associated procedures : coronary endarterectomy(14), coronary artery patch angioplasty(4), mitral valve repair(1), and repair of ventricular septal rupture(1). One patient died of low cardiac output syndrome and the others had no perioperative myocardial infarction. There are no ischemic and functional complications in the arm or hand after removal of the radial artery. Only 1 patient required reexploration of the arm, for the hematoma evacuation, and 2 patients complained transient thumb dysesthesia of the side of the havested arm. This dysesthesia improved within one month. Postoperative angiographic controls were obtained in 11 patients(31%) postoperative 79 to 210 days(mean 126 days). The patency rate were as follows : left internal mammary artery(100%), saphenous vein(100%), and radial artery(95%). We concluded that the radial artery is useful alternative graft, but long term clinical and angiographic studies are required to dertermine whether wider application is warranted.
Arm ; Cardiac Output, Low ; Coronary Artery Bypass* ; Coronary Vessels* ; Hand ; Hematoma ; Hospitals, General ; Humans ; Mammary Arteries ; Mitral Valve ; Myocardial Infarction ; Myocardial Revascularization ; Paresthesia ; Radial Artery ; Saphenous Vein ; Thumb ; Transplants