Activities of cardiac tissue matrix metalloproteinases 2 and 9 are reduced by remote ischemic preconditioning in cardiosurgical patients with cardiopulmonary bypass

Objective:to study potantial of remote ischemic preconditioning (RIP) as method of cardioprotection during coronary artery bypass surgery with cardiopulmonary bypass (CPB) and anesthesia with propofol.Materials and methods.We included in this study 87 patients (7 were excluded) with ischemic heart disease, hospitalized in the clinic of aortic and cardiovascular surgery of the I. M. Sechenov First Moscow State Medical University clinical hospital № 1. All patients had indications for direct myocardial revascularization by coronary artery bypass surgery. One day before operation patients were randomly assigned to 2 groups depending on preparation scheme: main group of RIP and the control group. The frequency of complications during surgery and in the postoperative period was assessed. Troponin I level was measured before, and in 2 and 24 hours after surgery. The level of lactate in the venous blood was measured before and after surgery.Results. Numbers of intraoperative and early postoperative complications in the main and control groups were similar. There were no differences between groups in troponin I and lactate levels after surgery.Conclusions.Remote ischemic preconditioning has no effect on the outcome of coronary artery bypass surgery with cardiopulmonary bypass and anesthesia with propofol.

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Remote Ischemic Preconditioning Attenuates Oxidative Stress during Cardiopulmonary Bypass

The Heart Surgery Forum ◽

10.1532/hsf.1590 ◽

2016 ◽

Vol 19 (4) ◽

pp. 192 ◽

Cited By ~ 5

Author(s):

Oiva Arvola ◽

Henri Haapanen ◽

Johanna Herajärvi ◽

Tuomas Anttila ◽

Ulla Puistola ◽

...

Keyword(s):

Oxidative Stress ◽

Cardiopulmonary Bypass ◽

Ischemic Preconditioning ◽

Circulatory Arrest ◽

Deep Hypothermic Circulatory Arrest ◽

Remote Ischemic Preconditioning ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Consecutive Series ◽

Blood Samples

Background: Deep hypothermic circulatory arrest (DHCA) is used to overcome the threat of cerebral ischemia during complex surgical operations of the heart and the aortic arch. Remote ischemic preconditioning (RIPC) has been shown to mitigate neurological damage. Methods: We analyzed blood samples in a consecutive series of 52 piglets that underwent a 60-min period of DHCA with RIPC (the RIPC group) or without (the control group), to reveal whether the protective effect to oxidative stress could be seen by measuring serum 8-hydroxydeoxyguanosine (8-OHdG). The piglets were cannulated and cooled to 18°C using a heart-lung machine, for the DHCA. The piglets were then rewarmed to normothermic temperature. Blood sampling was taken at baseline, after 30 minutes of cooling, 2 hours postoperatively, and 8 hours postoperatively, and analyzed. 8-hydroxydeoxyguanosine (8-OHdG) from blood samples was analyzed by using Enzyme Linked Immunosorbent Assay (ELISA). Results: The serum 8-OHdG concentration was lower in the RIPC group after the cooling phase, 1.84 (1.44-2.17) ng/mL, and at 8 hours after HCA 1.48 (1.39-1.69) ng/mL, when compared with the control group, where the values were 2.14 (1.81-2.56) and 1.84 (1.62-2.44) ng/mL, respectively (P = .025) and (P = .004). Conclusion: Remote ischemic preconditioning lowers oxidative stress during cardiopulmonary bypass.

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