Efficiency of L-arginine enriched cardioplegia and non-cardioplegic reperfusion in ischemic hearts

International Journal of Cardiology
Ugursay KiziltepeUmit Ozyurda

Abstract

Endothelial dysfunction with decreased nitric oxide (NO) levels has been implicated on reperfusion injury. Although L-arginine has been shown to diminish reperfusion injury in in vitro studies, clinical studies were very limited. Forty patients with acute myocardial ischemia undergoing CABG were randomized to a study and a control group. L-Arginine was added to cardioplegia solutions in study group. A non-cardioplegic warm blood solution with 8 mmol/l L-arginine infused for controlled reperfusion. Control patients received same protocol without L-arginine. Myocardial O2, lactate, nitrite and malondialdehyde extractions were measured in addition to calculation of CK-MB/CPK ratio and hemodynamic data. While there was no mortality in study group, one patient in control group died. Overall and nitrite (P=0.01) and lactate extractions (P=0.04) was higher in study and control groups, respectively. Myocardial O2 uptake was higher and malondialdehyde extraction was lower in study group. CK-MB/CPK ratio at postoperative sixth hour was also significantly lower in study group. Ninety percent of the study group had spontaneous return of the sinus rhythm, while 80% of the control patients required defibrillation (P<0.0001). In addition to s...Continue Reading

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Citations

May 29, 2007·Heart Failure Reviews·Antonio Rodríguez-SinovasDavid Garcia-Dorado
Jul 21, 2009·International Journal of Cardiology·Tong Liu, Guangping Li
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
Apr 29, 2016·Oxidative Medicine and Cellular Longevity·Daniel Fudulu, Gianni Angelini
Feb 28, 2015·Oxidative Medicine and Cellular Longevity·Mustafa ZakkarGianni D Angelini

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