Relation between left ventricular function and oxidative stress in patients undergoing bypass surgery
Relation between left ventricular function and oxidative stress in patients undergoing bypass surgery
复制标题
搭桥手术患者左心室功能与氧化应激的关系
作者：
E. De Vecchi;M. Pala;G. Di Credico;V. Agape;G. Paolini;P. Bonini;A. Grossi;R. Paroni
目的确定术前左心室射血分数（LVEF）是否与心脏搭桥术期间心肌氧化应激程度有关。设置三级护理中心。患者和干预措施31例患者（LVEF范围为20%至68%）接受择期冠状动脉搭桥术与血液心脏停搏液再灌注。在主动脉阻断前（T0）和开放后0（T1）、15（T2）和30（T3）分钟采集动脉和冠状窦血液。在T0和T1时，还从15例患者中获得了心室壁左心室活检。主要结果测量心肌活检中的谷胱甘肽和腺嘌呤核苷酸，而冠状窦动脉谷胱甘肽，核苷酸和脂质过氧化产物的差异计算从血液标本。在术后4小时和12小时测量血浆肌酸激酶（心肌带; CK-MB）。结果T0（r = 0.909和0.672）和T1（r = 0.603和0.605）时心肌谷胱甘肽和腺嘌呤核苷酸与术前LVEF均呈显著相关（p < 0.02）。再灌注期间心脏释放的氧化型谷胱甘肽与LVEF呈负相关（在T1、T2和T3时，r =-0.448、-0.466和-0461，p < 0.01），而还原型谷胱甘肽（r = 0.519和0.640在T1和T2）和谷胱甘肽氧化还原率（r = 0.647、0.714、0.645和0.702在T0、T1、T2和T3）显示出直接相关（p < 0.01）。T1时脂质过氧化与LVEF呈负相关（r =-0.492）。CK-MB与LVEF也呈负相关（4 h时r =-0.440，12 h时r =-0.462）。结论心肌缺血再灌注后抗氧化能力与心脏功能有关。
Objective To determine whether preoperative left ventricular ejection fraction (LVEF) is related to the degree of myocardial oxidative stress during bypass surgery in man. Design Observational study. Setting Tertiary care centre. Patients and interventions 31 patients (LVEF range was 20% to 68%) undergoing elective coronary bypass surgery with blood cardioplegic reperfusion were studied. Arterial and coronary sinus blood was collected before aortic cross clamping (T0) and at 0 (T1), 15 (T2), and 30 (T3) minutes after unclamping. Transmural left ventricular biopsies were also obtained from 15 patients at T0 and at T1. Main outcome measures Glutathione and adenine nucleotides were measured in myocardial biopsies, while coronary sinus–artery differences for glutathione, nucleotides, and products of lipid peroxidation were calculated from blood specimens. Creatine kinase (myocardial band; CK-MB) was measured in plasma at four and 12 hours after operation. Results Myocardial glutathione and adenine nucleotides were correlated (p < 0.02) with preoperative LVEF both at T0 (r = 0.909 and 0.672) and T1 (r = 0.603 and 0.605). Oxidised glutathione released from the heart during reperfusion was inversely correlated with LVEF (r = −0.448, −0.466, and −0461 at T1, T2, and T3, p < 0.01), while reduced glutathione (r = 0.519 and 0.640 at T1 and T2) and glutathione redox ratio (r = 0.647, 0.714, 0.645, and 0.702 at T0, T1, T2, and T3) showed a direct correlation (p < 0.01). Lipid peroxidation at T1 was negatively related to LVEF (r = −0.492). CK-MB was also negatively related to LVEF (r = −0.440 at 4 h and −0.462 at 12 h). Conclusions The capacity to counterbalance oxidative burst following ischaemia and reperfusion appears to be related to the functional ability of the heart.
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主动脉冠状动脉搭桥手术后通过门控心脏血池成像对左心室性能进行连续术后评估。
影响因子：
4.8
作者：
Reduto,LA;Lawrie,GM;Reid,JW;Whissenand,HH;Noon,GP;Kanon,D;DeBakey,ME;Miller,RR
通讯作者：
Miller,RR
影响因子：
15.9
作者：
BOLLI, R;PATEL, BS;MCCAY, PB
通讯作者：
MCCAY, PB
DOI：
10.1172/jci112001
发表时间：
1985-08
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
P. A. Ward;G. Till;J. Hatherill;T. M. Annesley;R. Kunkel
通讯作者：
P. A. Ward;G. Till;J. Hatherill;T. M. Annesley;R. Kunkel
参与挽救缺血心肌的因素：动脉血再灌注的影响。
影响因子：
37.8
作者：
Jennings,RB;Reimer,KA
通讯作者：
Reimer,KA