Efficacy and Mechanism of Preoperative Simvastatin Therapy on Myocardial Protection after Extracorporeal Circulation.
Efficacy and Mechanism of Preoperative Simvastatin Therapy on Myocardial Protection after Extracorporeal Circulation.
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术前辛伐他汀治疗对体外循环后心肌的保护作用及机制
DOI：
10.1155/2017/6082430
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发表时间：
2017
影响因子：
--
通讯作者：
Yang S
中科院分区：
文献类型：
--
作者：
Hua P;Liu J;Tao J;Zou R;Lin X;Zhang D;Yang S
体外循环（CPB）引起全身炎症反应和缺血再灌注（IR）损伤。 探讨辛伐他汀对体外循环心脏瓣膜手术中心肌损伤的影响及其机制。 130例患者被随机分配到他汀组（n = 65）或对照组（n = 65）。术前和术后给予辛伐他汀。记录重症监护室停留时间、辅助通气时间和左心室射血分数。分析血浆肌钙蛋白T（cTnT）、肌酸激酶同工酶（CK-MB）、肿瘤坏死因子α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）。观察心肌细胞超微结构及自噬体。检测心肌细胞Beclin-1、LC 3-II/I、P62、AMPK及AMPK磷酸化水平。 辛伐他汀组辅助通气时间显著缩短（P = 0.030），他汀组射血分数显著升高（P = 0.024）。辛伐他汀可显著降低cTnT、CK-MB、TNF-α、IL-6、IL-8水平（P < 0.05），降低LC 3-II/LC 3-I和Beclin 1的表达，增加AMPK磷酸化的表达。辛伐他汀可减少心肌细胞自噬体的产生，减轻心肌超微结构的损伤。 围手术期他汀类药物治疗通过调节心肌自噬和激活AMPK磷酸化来减轻心肌损伤。本研究的注册号为ChiCTR-TRC-14005164。
Cardiopulmonary bypass (CPB) causes systemic inflammatory response and ischemia-reperfusion (IR) injury. To investigate the effect and mechanism of simvastatin on myocardial injury in cardiac valve surgery with CPB. One hundred thirty patients were randomly assigned to the statin group (n = 65) or control group (n = 65). Simvastatin was administered preoperatively and postoperatively. Duration of intensive care unit stay, duration of assisted ventilation, and left ventricular ejection fraction were recorded. Plasma was analysed for troponin T (cTnT), isoenzyme of creatine kinase (CK-MB), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8). Ultrastructure of the myocardium and autophagosomes were observed. Beclin-1, LC3-II/I, P62, AMPK, and the phosphorylation of AMPK in cardiomyocytes were detected. Simvastatin significantly reduced the duration of assisted ventilation (P = 0.030) and ejection fraction was significantly higher in the statin group (P = 0.024). Simvastatin significantly reduced the levels of cTnT, CK-MB, TNF-α, IL-6, and IL-8 (P < 0.05), reduced the expression of LC3-II/LC3-I and Beclin 1, and increased the expression of phosphorylation of AMPK. Simvastatin reduced the generation of autophagosomes and the ultrastructural injuries to myocardium. Perioperative statin therapy reduced myocardial injury by regulating myocardial autophagy and activating the phosphorylation of AMPK. The registration number of this study is ChiCTR-TRC-14005164.
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DOI：
10.1016/j.jtcvs.2014.07.104
发表时间：
2014-12
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Sabe AA;Elmadhun NY;Sadek AA;Chu LM;Bianchi C;Sellke FW
通讯作者：
Sellke FW
影响因子：
4.4
作者：
Wang, Yanping;Kawamura, Nobutoshi;Low, Phillip A.
通讯作者：
Low, Phillip A.
影响因子：
8.8
作者：
Chello, M;Patti, G;Covino, E
通讯作者：
Covino, E
影响因子：
37.8
作者：
Davignon, J
通讯作者：
Davignon, J
影响因子：
2.2
作者：
Hedstrom, Erik;Astrom-Olsson, Karin;Arheden, Hakan
通讯作者：
Arheden, Hakan