scholarly journals Myocardial protection during elective coronary artery bypasses grafting by pretreatment with omega-3 polyunsaturated fatty acids

2013 ◽  
Vol 70 (5) ◽  
pp. 484-492 ◽  
Author(s):  
Milic Veljovic ◽  
Ana Popadic ◽  
Zoran Vukic ◽  
Radoje Ilic ◽  
Zoran Trifunovic ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Artery ◽  
Myocardial Protection ◽  
Oxygen Extraction ◽  
Controlled Study ◽  
Control Group ◽  
Omega 3 ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cross Clamp Time

Background/Aim. Despite recent advances in coronary artery bypass grafting (CABG), cardioplegic cardiac arrest and cardiopulmonary bypass (CPB) are still associated with myocardial injury. Accordingly, the efforts have been made lately to improve the outcome of CPB by glucose-insulinpotassium, adenosine, Ca2+-channel antagonists, L-arginine, N-acetylcysteine, coenzyme Q10, diazoxide, Na+/H+ exchange inhibitors, but with an unequal results. Since omega-3 polyunsatutated fatty acids (PUFAs) have shown remarkable cardioprotection in preclinical researches, the aim of our study was to check their effects in prevention of ischemia reperfusion injury in patients with CPB. Methods. This prospective, randomized, placebo-controlled study was performed with parallel groups. The patients undergoing elective CABG were randomized to receive preoperative intravenous omega-3 PUFAs infusion (n = 20) or the same volume of 0.9% saline solution infusion (n = 20). Blood samples were collected simultaneously from the radial artery and the coronary sinus before starting CPB and at 10, 20 and 30 min after the release of the aortic cross clamp. Lactate extraction/excretion and myocardial oxygen extraction were calculated and compared between the two groups. The levels of troponin I (TnT) and creatine kinase-myocardial band (CK-MB) were determined before starting CPB and 4 and 24 h postoperatively. Results. Demographic and operative characteristics, including CPB and aortic cross-clamp time, were similar between the two groups of patients. The level of lactate extraction 10 and 20 min after aortic cross-clamp time has shown negative values in the control group, but positive values in the PUFAs group with statistically significant differences (-19.6% vs 7.9%; p < 0.0001 and -19.9% vs 8.2%; p < 0.0008, respectively). The level of lactate extraction 30 minutes after reperfusion was not statistically different between the two groups (6.9% vs 4.2%; p < 0.54). Oxygen extraction in the PUFAs group was statistically significantly higher compared to the control group after 10, 20 and 30 min of reperfusion (35.5% vs 50.4%, p < 0.0004; 25.8 % vs 48.7%, p < 0.0001 and 25.8% vs 45.6%, p < 0.0002, respectively). The level of TnT, 4 and 24 h after CPB, was significantly higher in the control group compared to PUFAs group, with statistically significant differences (11.4 vs 6.6, p < 0.009 and 12.7 vs 5.9, p < 0.008, respectively). The level of CK-MB, 4 h after CPB, was significantly higher in the control group compared to PUFAs group (61.9 vs 37.7, p < 0.008), but its level, 24 h after CPB, was not statistically different between the two groups (58.9 vs 40.6, p < 0.051). Conclusion. Treatment with omega-3 PUFAs administered preoperatively promoted early metabolic recovery of the heart after elective CABG and improved myocardial protection. This study showed that omega-3 emulsion should not be considered only as a nutritional supplement but also as a clinically safe and potent cardioprotective adjunct during CPB.

Effect of Pexelizumab in Coronary Artery Bypass Graft Surgery With Extended Aortic Cross-Clamp Time

2006 ◽  
Vol 82 (3) ◽  
pp. 781-789 ◽  
Author(s):  
Peter K. Smith ◽  
Michel Carrier ◽  
John C. Chen ◽  
Axel Haverich ◽  
Jerrold H. Levy ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cross Clamp Time

scholarly journals Studying the effects of fish oil infusion to prevent atrial fibrillation after cardiac surgery: data from implantable continuous cardiac monitor

2015 ◽  
Vol 18 (3) ◽  
pp. 12
Author(s):  
S. M. Yefremov ◽  
Ye. A. Pokushalov ◽  
A. B. Romanov ◽  
A. M. Chernyavskiy ◽  
A. N. Shilova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Fatty Acids ◽  
Polyunsaturated Fatty Acids ◽  
Postoperative Atrial Fibrillation ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Omega 3 ◽  
Cardiac Monitor

The study was aimed at testing the hypothesis that perioperative infusion of omega-3 polyunsaturated fatty acids would reduce the incidence of postoperative atrial fibrillation in CAD patients operated under CPB. The authors carried out a prospective, randomised, double-blind, placebo-controlled study. 39 CAD patients who had undergone surgery under cardiopulmonary bypass were randomized into 2 groups. 18 patients were infused with omega-3 polyunsaturated fatty acids (Omegaven, Fresenius Kabi, Germany) starting with 200 mg/kg/day before anaesthesia induction for 24 hours followed by 100 mg/kg/day from second to seventh day postoperatively. 21 patients received an equivalent dose of placebo (Intralipid, Fresenius Kabi, Germany). The primary endpoint was freedom from atrial fibrillation at 2-year follow-up. A Reveal cardiac monitor was implanted subcutaneously in all patients. Data from cardiac monitor was collected on the 10th day and at 3, 6, 12 and 24 months postoperatively. Postoperative atrial fibrillation developed in 4 (19%) patients in the control group and in 5 (27.8%) patients in the study group at 10-day follow-up (p = 0.88). At 2-year follow-up, 5 (27.8%) patients in the control group and 6 (35.3%) patients in the study group had atrial fibrillation (p = 0.9). The results of our research do not confirm the efficiency of perioperative infusion of omega-3 polyun-saturated fatty acids to prevent the occurrence of atrial fibrillation.

scholarly journals Effect of pretreatment with omega-3 polyunsaturated fatty acids (PUFAs) on hematological parameters and platelets aggregation in patients during elective coronary artery bypass grafting

2013 ◽  
Vol 70 (4) ◽  
pp. 396-402 ◽  
Author(s):  
Milic Veljovic ◽  
Ivana Mihajlovic ◽  
Vesna Subota ◽  
Mirjana Antunovic ◽  
Jasna Jevdjic ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Arachidonic Acid ◽  
Coronary Artery ◽  
Platelet Aggregation ◽  
Polyunsaturated Fatty Acids ◽  
Coronary Artery Bypass ◽  
Hematological Parameters ◽  
Artery Bypass ◽  
Control Group ◽  
Omega 3

Bacground/Aim. Using omega-3 polyunsaturated fatty acids (PUFAs) in coronary artery bypass graft surgery (CABG) could provide protection against ischemicreperfusion damage, prevention of postoperative arrhythmia and attenuation of inflammatory response. However, omega-3 PUFAs inhibit cyclooxygenase (and thus decrease the synthesis of thromboxane A2 from arachidonic acid in platelets), which leads to decreased platelet aggregation. In cardiac surgery it is necessary to achieve a balance between inhibition and full platelets function. It is as well as important to closely follow hematological parameters, impaired by CABG itself. Therefore, the aim of the study was to establish the effects of pretreatment with omega- PUFAs on hematological parameters and plateletes aggregation in patients with elective CABG. Methods. This prospective, randomized, placebo-controlled, single-center trial was performed on parallel groups. The patients (n = 40) undergoing elective CABG were randomized receiving preoperative intravenous omega-3 PUFAs (Omegaven? 10%) infusion (the PUFAs group) or the same volume of 0.9% saline solution infusion (the control group). Infusion was given a day before surgery and repeated four hours before starting extracorporeal circulation (CPB) via the peripheral vein at single doses of 100 mL (25 mL/h). Platelet function analysis was performed using multiple electrode aggregometry (MEA, multiplate-analyzer) before starting CPB and 2 h postoperatively for the patients of both groups. Results. There were no clinically relevant differences in baseline characteristics between the groups. Hematological parameters were not significantly different between the groups pre-, intra- and postoperatively. During the first 24 h after surgery, the loss of blood was similar in the PUFAs and the control group (680 ? 274 mL and 608 ? 210 mL, respectively; p = 0.356). Postoperatively, platelet aggregation was not significantly different between the PUFAs and the control group in adenosine diphosphate (ADP) test (39 ? 11 and 42 ? 15, respectively; p = 0.701), arachidonic acid (ASPI) test (64 ? 24 and 70 ? 27, respectively; p = 0.525) and trombin receptor-activating peptide (TRAP) test (68 ? 25 and 75 ? 26, respectively; p = 0.396), while their aggregation in collagen (COL) test was statistically significantly lower in the PUFAs related to the control group (32 ? 15 and 47 ? 20, respectively; p = 0.009). Conclusion. Acute pretreatment with omega-3 PUFAs insignificantly affected the activity of platelets and did not influence postoperative blood loss.

Confounders of Cardioprotection by Remote Ischemic Preconditioning in Patients Undergoing Coronary Artery Bypass Grafting

Cardiology ◽  
2015 ◽  
Vol 133 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Petra Kleinbongard ◽  
Markus Neuhäuser ◽  
Matthias Thielmann ◽  
Eva Kottenberg ◽  
Jürgen Peters ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Ace Inhibitors ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cross Clamp Time ◽  
Β Blockers

Objectives: Remote ischemic conditioning (RIC) by repetitive blood pressure cuff inflation/deflation around a limb provides cardioprotection in patients undergoing coronary artery bypass grafting (CABG). Cardioprotection is confounded by risk factors, comorbidities and comedications. We aimed to identify confounders that possibly attenuate the protection provided by RIC. Methods: In a retrospective analysis of our single-center, randomized, double-blind trial of patients undergoing elective CABG with/without RIC prior to ischemic cardioplegic arrest, we analyzed demographics, medications and intraoperative variables. The primary end point was myocardial injury, as reflected by the area under the curve for serum troponin I (TnI) from baseline to 72 h after surgery. Results: In models with 2 independent variables and in the multivariate analysis, age and aortic cross-clamp time impacted on TnI release. Subgroup analyses confirmed RIC-induced protection in all age tertiles. There was no protection with an aortic cross-clamp time ≤56 min (RIC/control = 1.026 not significant), but there was protection with 57-75 min (RIC/control = 0.757; p = 0.0348) and ≥76 min (RIC/control = 0.735; p = 0.0277). Gender, β-blockers, statins, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) and intraoperative nitroglycerine did not impact on TnI release. Conclusion: Age, gender, β-blockers, statins, ACE inhibitors, ARBs and intraoperative nitroglycerine have no significant impact on RIC-induced cardioprotection during CABG. However, greater myocardial ischemia/reperfusion injury at longer cross-clamp time facilitates the detection of protection by RIC.

A randomized, double-blind, placebo-controlled study of polyunsaturated fatty acids efficacy in adolescents with anorexia nervosa

2020 ◽  
Vol 36 (2) ◽  
pp. 95-106
Author(s):  
Agnieszka M. Piróg-Balcerzak ◽  
Anna K. Bażyńska ◽  
Katarzyna Biernacka ◽  
Joanna Brągoszewska ◽  
Lidia Popek ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Anorexia Nervosa ◽  
Polyunsaturated Fatty Acids ◽  
Small Sample Size ◽  
Small Sample ◽  
Female Adolescent ◽  
Eating Attitude ◽  
Controlled Study ◽  
Omega 3 ◽  
Eat 26

Objective. Omega–3 polyunsaturated fatty acids (PUFAs) were tested in adolescent depression and in several neurodevelopmental disorders with partial success. Anorexia nervosa (AN) is characterised by deficiencies in fatty food intake and frequent comorbidity, including depressive and cognitive symptoms. Thus supplementation with PUFAs may be beneficial in this group of patients. The aim of the study was to assess whether PUFAs as an add-on treatment is associated with better improvement of body mass index (BMI) and psychopathological symptoms than placebo in patients with AN. Method. 61 female adolescent inpatients with AN were randomly allocated to omega–3 PUFAs supplementation or placebo for 10 weeks. Patients also participated in the behavioural programme and eclectic psychotherapy (treatment as usual, TAU). At baseline and follow-up visits, patients’ BMI and psychopathology were assessed with Clinical Global Impression Scale (CGI), Patient Global Impression Scale (PGI), and Eating Attitude Test (EAT-26). Results. After 10 weeks, both groups showed improvement in all parameters. Improvement in CGI scores was observed greater in placebo vs. PUFA-s group (p = 0.015) while other differences were not statistically significant. Omega–3 PUFAs supplementation appears not to be effective as an add-on treatment in inpatient adolescent girls with anorexia nervosa. Conclusions. The results should be analysed with caution due to small sample size and heterogeneity in TAU. As the TAU turned out to be highly effective, additional therapeutic effect of PUFA might not be visible. Nevertheless, that does not explain the tendency for better improvement in the placebo group.

Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

2015 ◽  
Vol 18 (4) ◽  
pp. 171 ◽  
Author(s):  
Tolga Demir ◽  
Mehmet Umit Ergenoglu ◽  
Hale Bolgi Demir ◽  
Nursen Tanrikulu ◽  
Mazlum Sahin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Myocardial Protection ◽  
Troponin T ◽  
Artery Bypass ◽  
Control Group ◽  
Study Group ◽  
Cabg Surgery ◽  
Anti Inflammatory ◽  
Pump Coronary Artery Bypass

<strong>Background</strong>: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB).<br /><strong>Methods</strong>: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. <br /><strong>Results</strong>: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P &lt; .001; T3: <br />P &lt; .001; T4: P &lt; .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group <br />(P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001).<br /><strong>Conclusions</strong>: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.<br /><br />

scholarly journals The Fatty Acid Profile in Patients with Newly Diagnosed Diabetes: Why It Could Be Unsuspected

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
C. Castro-Correia ◽  
S. Sousa ◽  
S. Norberto ◽  
C. Matos ◽  
V. F. Domingues ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Control Group ◽  
Healthy Children ◽  
Omega 3 ◽  
Alpha Linolenic Acid ◽  
Diabetes Group ◽  
Diabetic Children ◽  
Omega 6 ◽  
Diagnosed Diabetes

Context. Several studies have shown a link between proinflammatory activity and the presence or deficit of some fatty acids. Inflammation is associated with several diseases including diabetes.Objective. To characterize and compare the fatty acids profiles in children with inaugural type 1 diabetes, diabetic children (at least 1 year after diagnosis), and healthy children.Design. Plasma fatty acids profiles in children with inaugural diabetes, children with noninaugural diabetes, and controls, all of whom were prepubescent with a BMI < 85th percentile, were evaluated.Results. Omega-3 fatty acid levels were higher in recently diagnosed subjects with diabetes than in controls. The ratio of omega-6/omega-3 fatty acids was higher in the control population. Omega-6 fatty acid levels were higher in the nonrecent diabetic subjects than in the children with recently diagnosed diabetes, and the levels were higher in the nonrecent diabetes group compared to the control group.Conclusion. Our findings showed higher levels of alpha-linolenic acid, EPA, and DHA, as well as mono- and polyunsaturated fatty acids, in diabetic children. These findings reinforce the importance of precocious nutritional attention and intervention in the treatment of diabetic children.

scholarly journals Daytime Grazing in Mountainous Areas Increases Unsaturated Fatty Acids and Decreases Cortisol in the Milk of Holstein Dairy Cows

Animals ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 3122
Author(s):  
Jalil Ghassemi Nejad ◽  
Bae-Hun Lee ◽  
Ji-Yung Kim ◽  
Kyung-Il Sung ◽  
Hong-Gu Lee
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Dairy Cows ◽  
Milk Fat ◽  
Unsaturated Fatty Acids ◽  
Control Group ◽  
Milk Fatty Acid ◽  
Omega 3 ◽  
Mountainous Areas ◽  
Lactating Cows

The effects of grazing lactating cows in mountainous areas for 12 and 24 h compared with the confined indoor system were evaluated by examining the overall milk fatty acid and cortisol. Twenty-one dairy cows were allocated to three treatment groups: (1) control (confined management system in a free-stall barn; TMR based), (2) grazing for 12 h (12hG; TMR plus grazing pasture), and (3) grazing for 24 h (24hG; pasture-based feeding system). Dry matter intake was higher in the control and 12hG groups than in the 24hG group. The yields of total milk and the 3.5% fat-corrected milk were the lowest in the 24hG group. Milk fat was the highest in the 24hG group and higher in 12hG compared with the control group. Milk protein and lactose levels were the highest in the 12hG group. The highest somatic cell count was observed in the 24hG group. The saturated fatty acid levels were higher in the control group compared with the 12hG and 24hG groups. There was no difference in overall mono-unsaturated fatty acids between 12hG and 24hG groups. Poly-unsaturated fatty acids were higher in the 12hG group compared with the control and 24hG groups. There was no difference in omega-6 (ω-6) fatty acids among the groups, and omega-3 fatty acids were higher in the 12hG group than in the control group. Milk cortisol was the highest in the 24hG group and higher in the control group compared with the 12hG group. Taken together, grazing for 12 h is advisable for farms that have access to mountainous areas to improve the milk fatty acid profile and decrease the stress levels in high-yielding Holstein lactating cows.

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