PMID: 11899188Mar 20, 2002Paper

Cardioplegic arrest with L-arginine improves myocardial protection: results of a prospective randomized clinical trial

The Annals of Thoracic Surgery
M CarrierJoel Lavoie

Abstract

Blood cardioplegic arrest remains the method of choice for myocardial protection. L-arginine has been suggested to improve protection through an increase in nitric oxide production. A prospective, randomized, double-blinded clinical trial comparing standard blood cardioplegic solution to L-arginine-enriched solution (7.5 g/500 mL) enrolled 200 patients undergoing coronary artery bypass grafting. Clinical data and biochemical markers of ischemia were recorded. Warm blood cardioplegia (33 degrees C) was administered in 74% of patients and cold blood (20 degrees C) was used in 26% of patients. Both groups averaged three grafts per patient. There were two (2%) deaths in both groups. There were four (4%) myocardial infarctions (MI) in the control group and six (6%) infarctions in the L-arginine group (p = 0.5). For the 190 patients without MI, serum levels of troponin T averaged 0.40+/-0.43, 0.38+/-0.42, and 0.39+/-0.50 microg/L in control patients compared with 0.28+/-0.22, 0.24+/-0.18, and 0.27+/-0.20 microg/L in L-arginine patients, respectively, 12, 24 and 48 hours after coronary artery bypass grafting (p = 0.03). The cardiac index averaged 2.7+/-0.8 L x min(-1) x m(-2) in control patients and 2.9+/-0.7 L x min(-1) x m(-2) in ar...Continue Reading

References

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Citations

Sep 1, 2004·International Journal of Cardiology·Ugursay KiziltepeUmit Ozyurda
Sep 25, 2007·The Annals of Thoracic Surgery·Basel RamlawiFrank W Sellke
May 9, 2007·British Journal of Pharmacology·B K Podesser, S Hallström
Nov 28, 2007·Transplant International : Official Journal of the European Society for Organ Transplantation·Martine DesroisMonique Bernard
Dec 21, 2005·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Severin SemsrothBruno K Podesser
Aug 27, 2005·The Annals of Thoracic Surgery·Kerstin AmarkJan Sunnegårdh
Jul 13, 2007·Acta Cirúrgica Brasileira·Beatriz Martins Tavares-MurtaFlora Margarida Barra Bisinotto
May 29, 2004·Journal of Cardiovascular Pharmacology·Pál SoósGábor Szabó
Oct 13, 2010·Journal of Cardiovascular Pharmacology and Therapeutics·Alaaeldin I SalehMohamed Z Gad

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