[Preventive effect of post-ischemic reperfusion injury by terminal Nicorandil-Mg cardioplegia].
In this study, we evaluated the postischemic myocardial tissue blood flow, specific enzymes, and functional recovery infused with a Nicorandil vasodilator-magnesium solution (Nico.: 8 mg/L, Mg: 20 mEq/L) given just prior to reperfusion (Terminal Cardioplegia, TCP). 27 patients undergoing valve replacement were divided into two groups; the hearts of group non-TCP (nTCP) (n = 15) were reperfused after ischemia without TCP, and in the other hearts of group TCP (n = 12), TCP was given for 2 min prior to reperfusion. During the reperfusion period, myocardial tissue blood flow (TBF) on the anterior wall of left ventricle were monitored by a laser blood flow-meter. Thereafter, serum CK-MB levels, MM3/MM1 values by CK-MM subbands (MM1, MM2, MM3) levels and LVSWI were measured until 24 hours after surgery. At 5 and 10 min of reperfusion, Group TCP had a significantly greater TBF than Group nTCP (5 min; G-TCP: 69.9 +/- 19.0 ml/100 g.min, G-nTCP: 47.5 +/- 20.9, p less than 0.05, 10 min; G-TCP: 74.9 +/- 22.8, G-nTCP: 56.1 +/- 23.4, p less than 0.05). At 3 hrs after surgery, an increase of MM3/MM1 values was significantly suppressed in Group TCP compared to Group nTCP (G-TCP: 2.6 +/- 0.6, G-nTCP: 3.4 +/- 1.0, p less than 0.05). Also, Group TCP had better recovery of LVSWI. These results indicate that the TCP might reduce the postischemic reperfusion injury by the improvement of myocardial TBF and metabolism.
Orita
H
H
Second Department of Surgery, Yamagata University School of Medicine, Japan.
Fukasawa
M
M
Abe
H
H
Inui
K
K
Hirooka
S
S
Washio
M
M
D006324:Heart Arrest, Induced / Q000379:methods*; D006349:Heart Valve Diseases / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D020108:Nicorandil; D011188:Potassium / Q000627:therapeutic use; D017680:Potassium Compounds; D013318:Stroke Volume
D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D009536:Niacinamide; D020108:Nicorandil; D011188:Potassium