scholarly journals Remote Ischemic Preconditioning on New Onset Post-Cardiac Surgery Atrial Fibrillation: A Single-Centre Prospective Clinical Study

2019 ◽  
pp. 1-6
Author(s):  
Aidonidis Isaac ◽  
Aidonidis Isaac ◽  
Befani Christina ◽  
Dipla Konstantina ◽  
Hatziefthimiou Apostolia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Preconditioning ◽  
Troponin T ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Group Analysis ◽  
P Wave ◽  
Remote Ischemic Preconditioning ◽  
Control Group ◽  
Prospective Clinical Study

Background: Remote ischemic preconditioning (RIPC) has been shown to reduce myocardial ischemiareperfusion injury. However, its efficacy in preventing postoperative atrial fibrillation (POAF) remains unsettled. Methods: A total of 97 eligible patients were prospectively randomized to receive either RIPC or shamRIPC (control) prior to coronary artery bypass graft (CABG) surgery. RIPC was performed by applying 3 alternating cycles of a 5-min upper limb ischemia and reperfusion using a blood-pressure cuff. The primary endpoint was the incidence of POAF. Secondary endpoints included cardiac troponin T (cTnT) and H2O2 serum concentration after revascularization, and P-wave duration (PWD) on a 12-lead electrocardiogram. Results: Twelve out of 49 RIPC patients (24.5%) and 18/48 of control patients (37.5%) developed POAF (p=0.165, χ2-test). H2O2 levels were significantly increased 30 min after revascularization in both groups compared to pre-clamping values (8.8±6 vs 25.5±2 and 8.5±5 vs 39±15.5 µM/L in the RIPC and control group, respectively; P<.001, within-group analysis). However, mean differences of H2O2 levels after reperfusion were lower in RIPC patients than in controls (P<.05). cTnT concentrations though increased between 6 and 12 h after operation in both groups, they began to fall later only in the RIPC group. PWD became shorter in RIPC treated patients but not in controls when measured postoperatively (82±13 vs 75±11 ms, P<.01). Conclusion: RIPC did not significantly reduce the incidence of POAF despite decreases in cTnT/H2O2 levels and PWD, indicating that not the extent of myocardial injury but the injury itself triggers the electrophysiologic mechanisms underlying the development of this arrhythmia.

Perioperative cardiac troponin T and risk of postoperative atrial fibrillation in coronary artery bypass graft surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ali Vasheghani Farahani ◽  
Abbas Salehi Omran ◽  
Kyomars Abbasi ◽  
Ali Gholamrezaei ◽  
Pejman Mansouri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cardiac Troponin T ◽  
Artery Bypass Graft

Opioids in Remote Ischemic Preconditioning-Induced Cardioprotection

2016 ◽  
Vol 22 (2) ◽  
pp. 112-121 ◽  
Author(s):  
Puneet Kaur Randhawa ◽  
Amteshwar Singh Jaggi
Keyword(s):  
Ischemic Preconditioning ◽  
Ischemia Reperfusion ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Endogenous Opioids ◽  
Remote Ischemic Preconditioning ◽  
Endogenous Opioid System ◽  
Endogenous Opioid ◽  
Cardioprotective Effects

Remote ischemic preconditioning (RIPC) is an intriguing process whereby transient regional ischemia and reperfusion episodes to remote tissues including skeletal, renal, mesenteric provide protection to the heart against sustained ischemia–reperfusion-induced injury. Clinically, this technique has been used in patients undergoing various surgical interventions including coronary artery bypass graft surgery, abdominal aortic aneurysm repair, percutaneous coronary intervention, and heart valve surgery. The endogenous opioid system is extensively expressed in the brain to modulate pain sensation. Besides the role of opioids in relieving pain, numerous researchers have found their critical involvement in evoking cardioprotective effects. Endogenous opioids including endorphins, enkephalins, and dynorphins are released during RIPC and are critically involved in mediating RIPC-induced cardioprotective effects. It has been suggested that during RIPC, the endogenous opioids may be released into the systemic circulation and may travel via bloodstream that act on the myocardial opioid receptors to induce cardioprotection. The present review describes the potential role of opioids in mediating RIPC-induced cardioprotection.

Remote ischemic preconditioning effects on inflammatory markers and myocardial protection in coronary artery bypass graft surgery

Perfusion ◽  
2020 ◽  
pp. 026765912097929
Author(s):  
Farhad Gorjipour ◽  
Tahereh Saeedzadeh ◽  
Yaser Toloueitabar ◽  
Naser Kachoueian ◽  
Sepideh Bahlouli Ghashghaei ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Serum Level ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Ischemic Preconditioning ◽  
Myocardial Protection ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Remote Ischemic Preconditioning ◽  
Artery Bypass Graft

Background: Induction of short episodes of ischemia to remote organs, namely upper or lower limbs, literally known as remote ischemic preconditioning (RIPC) has been suggested as a preconditioning approach to ameliorate ischemia/reperfusion injury (IRI). RIPC has been demonstrated to effectively protect various vital organs, including heart, against the next ischemic events in preclinical studies. However, human studies are required to approve its clinical applicability. Present study was performed to evaluate the effect of RIPC on the myocardial protection and inflammatory response markers in patients undergoing coronary artery bypass graft surgery Methods: In this randomized clinical trial, 43 coronary artery bypass graft (CABG) patients from Imam Hossein educational hospital were allocated in two groups, RIPC (21 patients) and control (22 patients). Serum level of interleukin (IL)-4, IL-8, and IL-10, interferon (IFN)-γ and Cardiac Troponin-I (cTnI) were measured in (1) after induction of anesthesia (before incision of skin), (2) after separation from CPB and (3) 24 hours after ICU arrival. Results: increase pack cell transfusions were observed in control group in ICU. Serum level of IL-10 at 24 hours after ICU admission was significantly higher in the RIPC group. Significantly lower amounts of IL-8 at post-CPB time were observed in the RIPC group in comparison with control. Conclusion: RIPC regulates the circulatory inflammatory cytokines, IL-8 decrement and IL-10 elevation, which could be translated into protection against IRI. However, further studies with larger sample sizes with careful consideration of parameters such as use of propofol as an anesthetic in the patients should be conducted to consolidate the findings from the current study.

scholarly journals Role of Magnesium Sulphate for Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Open Heart Bypass (CABG) Surgery

2012 ◽  
Vol 8 (1) ◽  
pp. 12-14
Author(s):  
Ashia Ali ◽  
Md Kamrul Hassan ◽  
Mostofa Nuruzzaman ◽  
Sumsu Zzaman ◽  
Mostafizur Rahman ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Single Dose ◽  
Magnesium Sulphate ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
Cabg Surgery ◽  
Cardiac Anaesthesia ◽  
Pace Maker

To assess the role of magnesium sulphate infusion after coronary artery bypass graft (CABG) surgery in  preventing atrial arrhythmias that may occur following CABG operation. Cardiac anaesthesia wing of   Bangabandhu Sheik Mujib Medical University, Dhaka from 2007 to 2009. Design: Prospective randomized  non blined. All patients under going primary CABG surgery and having sinus rhythm before surgery were alternatively randomized into the study or control group. Patient with history of Atrial Fibrillation (AF), Left   Atrial (LA) dysfunction, renal-impairment and implanted pace maker were excluded from the study. The patients in the study group received 10 mmol of magnesium (2.47gm) in 10 ml saline intravenously over 10 min after termination of Cardio Pulmonary Bypass (CPB). The end point was development 0f AF for 10 min   or if an episode of AF had to be treated because of symptoms. A total of 60 patients were included in the study 30 in each group. The incident of AF was 14% in patients who received single dose of magnesium. The  patients without magnesium had an AF incidence of 20% (p=0.353) not significant. Single dose magnesium infusion does not prevent AF statistically, but the haemodynamic parameters in patients receiving magnesium were more stable during the whole period of observation. DOI: http://dx.doi.org/10.3329/uhj.v8i1.11661 University Heart Journal Vol. 8, No. 1, January 2012

The effects of melatonin on the oxidative stress and duration of atrial fibrillation after coronary artery bypass graft surgery: A Randomized Controlled Trial

2020 ◽  
Vol 20 ◽  
Author(s):  
Saghar Barati ◽  
Alireza Jahangirifard ◽  
Zargham Hossein Ahmadi ◽  
Maria Tavakoli-Ardakani ◽  
Farzaneh Dastan
Keyword(s):  
Oxidative Stress ◽  
Atrial Fibrillation ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
P Value ◽  
Artery Bypass Graft ◽  
Cabg Surgery ◽  
Significant Difference ◽  
Hs Crp

Background: Atrial Fibrillation (AF) is a common complication following Coronary artery bypass graft (CABG) Surgery, which may be due to oxidative stress, necrosis and inflammation during CABG and can lead to increases the length of hospital stay and the risk of morbidity and mortality. Melatonin is a hormone with anti-oxidant and anti-inflammatory properties in the cardiovascular system. This study assessed the efficacy of sublingual consumption of melatonin in reducing necrosis and inflammation, in patients undergoing CABG with respect to C-reactive protein (hs-CRP), Creatine KinaseMuscle-Brain subunits (CK-MB) and cardiac Troponin T (cTnT) levels. Methods: One hundred and two patients were enrolled and twenty-six patients were excluded during the study process and finally seventy-six patients undergoing CABG surgery randomly assigned to melatonin group (n = 38, 12 mg sublingual melatonin the evening before and 1 hour before surgery, or the control group which did not receive Melatonin, n = 38). Three patients in the melatonin group and three patients in the control group were excluded from the study because of discontinued intervention and lost to follow up. The samples were collected before and 24 hours after surgery. hs-CRP, CKMB, and cTnT levels were measured in all patients with the Elisa method. Results: There was no significant difference in influencing variables among the groups at the baseline. The incidence of AF following CABG surgery was not statistically significant between the two groups, (p value = 0.71). However, the duration of AF (p value = 0.01), the levels of hs-CRP (p value = 0.001) and CK-MB (p value = 0.004) measured, 24 hours after surgery were significantly lower in the melatonin group. cTnT levels measured 24 hours post-CABG did not show any significant difference in both groups (p value = 0.52). Conclusion: Our findings suggest that the administration of melatonin may help modulate oxidative stress, based on the reduction of the levels of hs-CRP, CK-MB, and the duration of AF following CABG surgery.

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